Tsukamoto Masayo, Yamashita Yo-Ichi, Imai Katsunori, Umezaki Naoki, Yamao Takanobu, Okabe Hirohisa, Nakagawa Shigeki, Hashimoto Daisuke, Chikamoto Akira, Ishiko Takatoshi, Yoshizumi Tomoharu, Maehara Yoshihiko, Baba Hideo
Department of Gastroenterological Surgery, Kumamoto University Graduate School of Life Sciences, Kumamoto, Japan.
Department of Gastroenterological Surgery, Kumamoto University Graduate School of Life Sciences, Kumamoto, Japan
Anticancer Res. 2017 Dec;37(12):6971-6975. doi: 10.21873/anticanres.12164.
BACKGROUND/AIM: Intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver cancer after hepatocellular carcinoma, and has a poor prognosis. Surgical resection is the only option for a cure of ICC. Here we attempted to define the cure rate after hepatic resection for ICC and to identify the predictors for a cure.
Among the 96 patients who underwent R0 resections for primary ICC between 1990 and 2011 at the Kumamoto University Hospital and Kyushu University Hospital, those who were followed for ≥5 years after surgery were enrolled. "Cure" was defined as recurrence-free survival (RFS) of ≥5 years after surgery.
A total of 81 patients were eligible. A cure was achieved in 37 patients (45.7%). The 5-year overall survival and RFS rates were 55.0% and 41.7%, respectively. A multivariate logistic regression analysis identified the absence of lymph node metastasis (relative risk (RR) 7.5, p=0.011) and the absence of microvascular invasion (RR 5.5, p=0.0137) as the independent predictors of achieving a cure.
R0 resections achieved a cure in 45.7% of this series of ICC patients. The predictors of a cure identified here, i.e., absence of lymph node metastasis and absence of microvascular invasion, could contribute to the selection of patients who are not candidates for adjuvant chemotherapy.
背景/目的：肝内胆管癌（ICC）是仅次于肝细胞癌的第二常见原发性肝癌，预后较差。手术切除是治愈ICC的唯一选择。在此，我们试图确定ICC肝切除术后的治愈率，并找出治愈的预测因素。
在1990年至2011年间于熊本大学医院和九州大学医院接受原发性ICC根治性切除的96例患者中，纳入术后随访≥5年的患者。“治愈”定义为术后无复发生存（RFS）≥5年。
共有81例患者符合条件。37例患者（45.7%）实现治愈。5年总生存率和无复发生存率分别为55.0%和41.7%。多因素逻辑回归分析确定无淋巴结转移（相对危险度（RR）7.5，p = 0.011）和无微血管侵犯（RR 5.5，p = 0.0137）是实现治愈的独立预测因素。
本系列ICC患者中，根治性切除使45.7%的患者实现治愈。此处确定的治愈预测因素，即无淋巴结转移和无微血管侵犯，有助于筛选出不适合辅助化疗的患者。
