Zhou Yan-Ming, Sui Cheng-Jun, Zhang Xiao-Feng, Li Bin, Yang Jia-Mei
Department of Hepatobiliary & Pancreatovascular Surgery, First affiliated Hospital of Xiamen University, Xiamen, China.
Department of Special Treatment, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
BMC Gastroenterol. 2017 Feb 10;17(1):25. doi: 10.1186/s12876-017-0584-y.
Little is known about the prognostic impact of cirrhosis on long-term survival of patients with combined hepatocellular-cholangiocarcinoma (cHCC-CC) after hepatic resection. The aim of this study was to elucidate the long-term outcome of hepatectomy in cHCC-CC patients with cirrhosis.
A total of 144 patients who underwent curative hepatectomy for cHCC-CC were divided into two groups: cirrhotic group (n = 91) and noncirrhotic group (n = 53). Long-term postoperative outcomes were compared between the two groups.
Patients with cirrhosis had worse preoperative liver function, higher frequency of HBV infection, and smaller tumor size in comparison to those without cirrhosis. The 5-year overall survival rate in cirrhotic group was significantly lower than that in non-cirrhotic group (34.5% versus 54.1%, P = 0.032). The cancer recurrence-related death rate was similar between the two groups (46.2% versus 39.6%, P = 0.446), while the hepatic insufficiency-related death rate was higher in cirrhotic group (12.1% versus 1.9%, P = 0.033). Multivariate analysis indicated that cirrhosis was an independent prognostic factor of poor overall survival (hazard ratio 2.072, 95% confidence interval 1.041-4.123; P = 0.038).
The presence of cirrhosis is significantly associated with poor prognosis in cHCC-CC patietns after surgical resection, possibly due to decreased liver function.
关于肝硬化对肝切除术后肝细胞-胆管细胞癌（cHCC-CC）患者长期生存的预后影响知之甚少。本研究的目的是阐明肝硬化的cHCC-CC患者肝切除术后的长期结局。
总共144例行cHCC-CC根治性肝切除术的患者被分为两组：肝硬化组（n = 91）和非肝硬化组（n = 53）。比较两组术后的长期结局。
与无肝硬化患者相比，肝硬化患者术前肝功能较差，HBV感染频率较高，肿瘤较小。肝硬化组的5年总生存率显著低于非肝硬化组（34.5%对54.1%，P = 0.032）。两组的癌症复发相关死亡率相似（46.2%对39.6%，P = 0.446），而肝硬化组的肝衰竭相关死亡率较高（12.1%对1.9%，P = 0.033）。多因素分析表明，肝硬化是总生存不良的独立预后因素（风险比2.072，95%置信区间1.041 - 4.123；P = 0.038）。
肝硬化的存在与cHCC-CC患者手术切除后的预后不良显著相关，可能是由于肝功能下降所致。
