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肝内胆管细胞癌和肝细胞癌-胆管细胞癌联合切除术后患者的预后。

Patients' prognosis of intrahepatic cholangiocarcinoma and combined hepatocellular-cholangiocarcinoma after resection.

机构信息

Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.

出版信息

Cancer Med. 2019 Oct;8(13):5862-5871. doi: 10.1002/cam4.2495. Epub 2019 Aug 13.

Abstract

Combined hepatocellular-cholangiocarcinoma (cHCC-CC) and intrahepatic cholangiocarcinoma (ICC) are classified into one category, but comparison of prognosis of the two carcinomas remains controversial. The aim of the current study was to investigate surgical outcomes for patients with ICC or cHCC-CC who underwent resection in order to elucidate whether the classification of ICC and cHCC-CC is justified. Subjects were 61 patients with ICC and 29 patients with cHCC-CC who underwent liver resection from 2001 to 2017. Clinic-pathological data from the two groups were compared. Tumor number and vascular invasion were independent risk factors for recurrence-free survival (RFS) in both groups (P < .001 for both). Of note, for patients with ICC, tumor cut-off size of 5 cm showed statistical significance in median RFS (>5 cm vs ≤5 cm, 0.5 years vs 4.0 years, P = .003). For patients with cHCC-CC, tumor cut-off size of 2 cm showed statistical significance in median RFS (>2 cm vs ≤2 cm, 0.6 years vs 2.6 years, P = .038). The median RFS of patients with cHCC-CC was 0.9 years (95% confidence interval: 0.3-1.6), which was poorer than that of patients with ICC (1.3 years, 0.5-2.1) (P = .028); the rate of RFS at 5 years was 0% and 37.7% respectively. Our study supports the concept of classifying ICC and cHCC-CC into different categories because of a significant difference in RFS between the two.

摘要

混合型肝细胞癌-胆管细胞癌(cHCC-CC)和肝内胆管细胞癌(ICC)被归为同一类别,但两种癌的预后比较仍存在争议。本研究旨在探讨接受肝切除术的 ICC 或 cHCC-CC 患者的手术结果,以阐明将 ICC 和 cHCC-CC 进行分类是否合理。研究对象为 2001 年至 2017 年间接受肝切除术的 61 例 ICC 患者和 29 例 cHCC-CC 患者。比较两组的临床病理数据。肿瘤数量和血管侵犯是两组患者无复发生存期(RFS)的独立危险因素(均 P<0.001)。值得注意的是,对于 ICC 患者,肿瘤大小截点为 5cm 时,中位 RFS 具有统计学意义(>5cm 与≤5cm 相比,0.5 年与 4.0 年,P=0.003)。对于 cHCC-CC 患者,肿瘤大小截点为 2cm 时,中位 RFS 具有统计学意义(>2cm 与≤2cm 相比,0.6 年与 2.6 年,P=0.038)。cHCC-CC 患者的中位 RFS 为 0.9 年(95%置信区间:0.3-1.6),低于 ICC 患者(1.3 年,0.5-2.1)(P=0.028);5 年 RFS 率分别为 0%和 37.7%。本研究支持将 ICC 和 cHCC-CC 分为不同类别的概念,因为两组患者的 RFS 存在显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29b7/6792494/cb902155b61f/CAM4-8-5862-g001.jpg

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