Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan.
Dig Surg. 2017;34(6):476-482. doi: 10.1159/000456082. Epub 2017 Feb 7.
BACKGROUND/AIMS: Although biliary tract cancer is generally associated with a high mortality rate, patients with distal cholangiocarcinoma have better prognoses, compared to those with periampullary cancer. This study aimed to determine the preoperative clinicophysiological factors predictive of survival and recurrence in patients with distal cholangiocarcinoma.
Forty-five patients (34 men) with distal cholangiocarcinoma who underwent pancreaticoduodenectomy between 2005 and 2013 were examined retrospectively at our center and associated hospitals. Clinicophysiological parameters included predictors of overall survival (OS). Kaplan-Meier survival curves were generated and compared using log-rank tests, and Cox proportional hazard multivariate analyses were performed.
The mean patient age was 68.8 years (range 54-81 years). Patients had a median OS duration of 43 months, and 1-, 3-, and 5-year OS rates of 91.1, 61.1, and 40.4%, respectively. Univariate analyses indicated that the body mass index, C-reactive protein (CRP) level, and carcinoembryonic antigen level were independent prognostic factors for OS; however, only the CRP level remained an independent prognostic factor in a multivariate analysis.
A CRP level <0.3 mg/dL was predictive of a better outcome among patients with distal cholangiocarcinoma.
背景/目的：尽管胆道癌通常与高死亡率相关，但与壶腹周围癌相比，远端胆管癌患者的预后更好。本研究旨在确定预测远端胆管癌患者生存和复发的术前临床生理因素。
本中心和附属医院回顾性检查了 2005 年至 2013 年间接受胰十二指肠切除术的 45 例（34 名男性）远端胆管癌患者。临床生理参数包括总生存（OS）的预测因子。通过对数秩检验生成 Kaplan-Meier 生存曲线并进行比较，并进行 Cox 比例风险多因素分析。
患者的平均年龄为 68.8 岁（54-81 岁）。中位 OS 时间为 43 个月，1、3 和 5 年 OS 率分别为 91.1%、61.1%和 40.4%。单因素分析表明，体重指数、C 反应蛋白（CRP）水平和癌胚抗原水平是 OS 的独立预后因素；然而，在多因素分析中，只有 CRP 水平仍然是一个独立的预后因素。
CRP 水平<0.3mg/dL 可预测远端胆管癌患者的预后更好。
