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.
HPB (Oxford). 2020 Mar;22(3):405-414. doi: 10.1016/j.hpb.2019.07.011. Epub 2019 Sep 4.
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.
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.
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.
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.
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。
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。
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。
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。
