泰国东北部肝门周围胆管癌根治性切除的结果
Outcome of curative resection for perihilar cholangiocarcinoma in Northeast Thailand.
作者信息
Titapun Attapol, Pugkhem Ake, Luvira Vor, Srisuk Tharatip, Somintara Ongart, Saeseow O-Tur, Sripanuskul Anan, Nimboriboonporn Anongporn, Thinkhamrop Bandit, Khuntikeo Narong
机构信息
Attapol Titapun, Ake Pugkhem, Vor Luvira, Tharatip Srisuk, Ongart Somintara, O-tur Saeseow, Anan Sripanuskul, Anongporn Nimboriboonporn, Narong Khuntikeo, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
出版信息
World J Gastrointest Oncol. 2015 Dec 15;7(12):503-12. doi: 10.4251/wjgo.v7.i12.503.
AIM
To examine survival outcomes of perihilar cholangiocarcinoma (PCCA) resection including mortality, morbidity and prognostic factors.
METHODS
Multivariate analyses were carried out based on the survival data of all patients with histologically confirmed PCCA who underwent curative resection at Srinagarind Hospital from January 2006 to December 2011.
RESULTS
There were 29 (19%) cases of intrahepatic CCA that involved hilar and 124 (81%) with hilar bile-duct cancer. R0 resection was carried out on 66 (43.1%) patients of whom 50 (32.7%) also had lymph node metastasis. The other patients underwent R1 resection. The overall 5-year survival rate was 20.6% (95%CI: 13.8-28.4) and median survival time was 19.9 mo. Postoperative mortality was 2%, and 30% of patients had complications. Patients without lymph node metastasis were 60% less likely to die than those with metastasis. Achieving R0 led to a 58% reduction in the chance of mortality as compared to R1.
CONCLUSION
To achieve a better survival outcome, focus should center on performing radical surgery and detection of patients with early stage cancer.
目的
探讨肝门部胆管癌（PCCA）切除术后的生存结局，包括死亡率、发病率及预后因素。
方法
基于2006年1月至2011年12月在诗里拉吉医院接受根治性切除的所有经组织学确诊为PCCA患者的生存数据进行多因素分析。
结果
29例（19%）肝内胆管癌累及肝门部，124例（81%）为肝门部胆管癌。66例（43.1%）患者行R0切除，其中50例（32.7%）伴有淋巴结转移。其他患者行R1切除。总体5年生存率为20.6%（95%CI：13.8 - 28.4），中位生存时间为19.9个月。术后死亡率为2%，30%的患者出现并发症。无淋巴结转移的患者死亡可能性比有转移的患者低60%。与R1切除相比，实现R0切除可使死亡几率降低58%。
结论
为获得更好的生存结局，应着重进行根治性手术并检测早期癌症患者。
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