Ma Chung Hyeun, Hwang Dae Wook, Song Ki Byung, Kim Song Cheol, Shin Sang Hyun, Lee Jae Hoon
Department of Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ann Surg Treat Res. 2020 Mar;98(3):116-123. doi: 10.4174/astr.2020.98.3.116. Epub 2020 Feb 28.
Hepatic resection is considered as the optimal treatment for intrahepatic cholangiocarcinoma (IHCC); however, the survival rate after resection is low and the analysis of long-term (≥10 years) survivors is rare. This study aims to analyze the clinicopathological factors affecting the long-term survival of patients with IHCC.
Between January 2003 and December 2012, a single-institution cohort of 429 patients who underwent hepatic resection for IHCC were reviewed retrospectively. Surgical results, recurrence, and survival rates were investigated, and multivariate analyses were performed to identify prognostic factors.
The overall 1- , 3- , 5- and 10-year survival rates of patients were 76.5%, 44.1%, 33.3%, and 25.1%, respectively. Multivariate analysis showed that the serum CA 19-9 level (≥38 U/mL) (P < 0.001), lymph node (LN) metastasis (P = 0.001), and lymphovascular invasion (LVI) (P = 0.012) were independent factors associated with overall survival. In particular, CA 19-9 level and histologic type were determined to be independent factors affecting survival for more than 10 years.
CA 19-9 (≥38 U/mL), LN metastasis, and LVI were identified as independent risk factors for survival after resection of IHCC. CA 19-9 (<38 U/mL) and histologic type were independent factors predicting survival for more than 10 years.
肝切除术被认为是肝内胆管癌（IHCC）的最佳治疗方法；然而，切除术后的生存率较低，对长期（≥10年）生存者的分析很少见。本研究旨在分析影响IHCC患者长期生存的临床病理因素。
回顾性分析2003年1月至2012年12月期间在单一机构接受肝切除术治疗IHCC的429例患者的队列。调查手术结果、复发情况和生存率，并进行多因素分析以确定预后因素。
患者的1年、3年、5年和10年总生存率分别为76.5%、44.1%、33.3%和25.1%。多因素分析显示，血清CA 19-9水平（≥38 U/mL）（P < 0.001）、淋巴结（LN）转移（P = 0.001）和淋巴管侵犯（LVI）（P = 0.012）是与总生存相关的独立因素。特别是，CA 19-9水平和组织学类型被确定为影响生存超过10年的独立因素。
CA 19-9（≥38 U/mL）、LN转移和LVI被确定为IHCC切除术后生存的独立危险因素。CA 19-9（<38 U/mL）和组织学类型是预测生存超过10年的独立因素。
