在西方高容量中心，切除的胆道癌解剖亚型的短期和长期结果比较。
Comparison of short- and long-term outcomes between anatomical subtypes of resected biliary tract cancer in a Western high-volume center.
机构信息
Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands.
Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands.
出版信息
HPB (Oxford). 2020 Mar;22(3):405-414. doi: 10.1016/j.hpb.2019.07.011. Epub 2019 Sep 4.
BACKGROUND
Outcomes for the four anatomical subtypes of biliary tract carcinoma (BTC) - intrahepatic, perihilar and distal cholangiocarcinoma (ICC, PHCC, DCC) and gallbladder carcinoma (GBC) - are often combined. However, large cohorts comparing short- and long-term outcomes for the anatomical subtypes of BTC are lacking.
METHODS
All patients who underwent resection for pathology proven ICC, PHCC, DCC or GBC (2000-2016) from a single Western high-volume center were retrospectively selected. Clinicopathological characteristics, short- and long-term outcomes were compared between the four anatomical subtypes.
RESULTS
Overall, 361 patients with resected BTC were included (33 ICC, 135 PHCC, 148 DCC, 45 GBC). Clavien-Dindo grade III or higher complications were 48%, 51%, 36% and 8% (p < 0.001) and 90-day mortality was 9%, 15%, 3%, 4% (p < 0.001), for ICC, PHCC, DCC, GBC. Median overall survival was 37, 42, 29 and 41 months (p = 0.722), for ICC, PHCC, DCC, GBC. Five-year survival ranged between 29% and 37%. Anatomical subtype was not an independent predictor for overall survival.
CONCLUSION
In this large single-center cohort of resected BTC, major morbidity and 90-day mortality varied between the four anatomical subtypes of BTC, mainly due to differences in surgical approach However, a significant difference in overall survival was not detected.
背景
四种解剖学亚型的胆道癌（BTC）——肝内、肝门周围和远端胆管癌（ICC、PHCC、DCC）和胆囊癌（GBC）——的预后通常被合并在一起。然而，缺乏比较 BTC 解剖学亚型的短期和长期结果的大型队列研究。
方法
回顾性地选择了来自单一西方大容量中心的经病理证实的 ICC、PHCC、DCC 或 GBC 患者（2000-2016 年），并对其进行手术切除。比较了四种解剖学亚型的临床病理特征、短期和长期结果。
结果
共纳入 361 例接受 BTC 切除术的患者（33 例 ICC、135 例 PHCC、148 例 DCC、45 例 GBC）。Clavien-Dindo 分级 III 或更高的并发症发生率分别为 48%、51%、36%和 8%（p<0.001），90 天死亡率分别为 9%、15%、3%、4%（p<0.001），ICC、PHCC、DCC、GBC。ICC、PHCC、DCC 和 GBC 的中位总生存期分别为 37、42、29 和 41 个月（p=0.722）。5 年生存率在 29%至 37%之间。解剖学亚型不是总生存期的独立预测因素。
结论
在这项大型单中心 BTC 切除患者队列研究中，四种 BTC 解剖学亚型之间的主要发病率和 90 天死亡率存在差异，主要是由于手术方法的不同。然而，总体生存无显著差异。
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