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根治性切除术后复发性肝内胆管细胞癌患者的预后因素:一项回顾性队列研究。

Prognostic factors in patients with recurrent intrahepatic cholangiocarcinoma after curative resection: A retrospective cohort study.

机构信息

Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.

Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.

出版信息

Int J Surg. 2018 Jun;54(Pt A):156-162. doi: 10.1016/j.ijsu.2018.04.058. Epub 2018 May 3.

Abstract

BACKGROUND

The aim of this study is to determine the outcomes and prognostic factors in patients with recurrent intrahepatic cholangiocarcinoma after curative hepatectomy.

METHODS

Clinical, histopathological, and treatment data of 53 patients with recurrent cholangiocarcinoma after curative resection from 2005 to 2015 at our institutes were investigated and analyzed by univariate and multivariate analyses (E-788).

RESULTS

Recurrent cholangiocarcinoma occurred in 53 of 97 patients who underwent curative resection for intrahepatic cholangiocarcinoma. The median overall survival after recurrence was 13.6 months (range, 1-55 months). Multivariate analysis revealed that recurrent treatment without surgery (p = 0.0007), gross appearance except for mass-forming type (p = 0.0183) and bile duct invasion at the initial surgery (p = 0.0093) were significant poor prognostic factors in recurrent cholangiocarcinoma. Median survival of patients after surgical treatment for recurrent cholangiocarcinoma was 36.7 months versus 13.1 months in patients who did not undergo surgery (p = 0.029).

CONCLUSIONS

Surgical treatment, gross appearance in mass-forming type and the absence of bile duct invasion were independent favorable factors for survival among patients with recurrent cholangiocarcinoma. We recommend surgical treatment for localized recurrence, even if it occurs early after the initial hepatectomy.

摘要

背景

本研究旨在确定根治性肝切除术后复发性肝内胆管癌患者的结局和预后因素。

方法

对 2005 年至 2015 年在我院接受根治性切除术后复发的 53 例胆管癌患者的临床、组织病理学和治疗数据进行了调查和分析,并进行了单因素和多因素分析(E-788)。

结果

97 例接受肝内胆管癌根治性切除术的患者中,有 53 例发生复发性胆管癌。复发后总生存期的中位数为 13.6 个月(范围 1-55 个月)。多因素分析显示,复发时未行手术治疗(p=0.0007)、除肿块型外大体外观(p=0.0183)和初始手术时胆管侵犯(p=0.0093)是复发性胆管癌的显著不良预后因素。复发性胆管癌患者行手术治疗后的中位生存时间为 36.7 个月,而未行手术治疗的患者为 13.1 个月(p=0.029)。

结论

手术治疗、肿块型大体外观和无胆管侵犯是复发性胆管癌患者生存的独立有利因素。即使在初始肝切除术后早期发生局部复发,我们也建议进行手术治疗。

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