Department of Hepatobiliary and Pancreatic Surgery, Ganzhou People's Hospital, The Affiliated Ganzhou Hospital of Nanchang University, , Ganzhou, Jiangxi.
Nanchang University, Nanchang, Jiangxi.
Eur J Gastroenterol Hepatol. 2024 Aug 1;36(8):1029-1037. doi: 10.1097/MEG.0000000000002799. Epub 2024 May 31.
Extrahepatic bile duct cancer (EBDC) is a compound malignant tumor mainly consisting of extrahepatic cholangiocarcinoma and gallbladder carcinoma. Most EBDC patients are diagnosed at an advanced stage characterized by distant metastases, and the liver is one of the common sites of metastasis. Hence, the purpose of this study is to investigate the clinicopathological features, identify prognostic risk factors, and assess the long-term prognosis of extrahepatic bile duct cancer liver metastasis (EBDCLM).
We identified 1922 eligible EBDCLM patients from the SEER database.Cox regression models were used to predict independent prognostic factors for overall survival (OS) and cancer-specific survival (CSS),and Kaplan-Meier survival curves were drawn. A nomogram was constructed based on the results of multivariate Cox analysis, and the predictive effect of the nomogram was evaluated.
Age, surgery, chemotherapy, brain metastasis, and lung metastasis were common independent prognostic factors for OS and CSS, and radiotherapy and bone metastasis were independent prognostic factors for CSS. The Kaplan-Meier survival curves showed a significant increase in survival for patients aged less than or equal to 70 years, undergoing surgery and chemotherapy, and without lung metastases. The results showed that the nomogram constructed by us had good predictability and ha d strong clinical application value.
Our study identified age, surgery, chemotherapy, brain metastasis, and lung metastasis as independent prognostic factors for EBDCLM patients. The nomogram can accurately predict the survival probability, which is helpful for clinicians to assess the prognosis of patients with advanced EBDC and provide personalized clinical decisions.
肝外胆管癌（EBDC）是一种复合恶性肿瘤，主要由肝外胆管癌和胆囊癌组成。大多数 EBDC 患者在晚期被诊断，其特征为远处转移，肝脏是常见的转移部位之一。因此，本研究旨在探讨肝外胆管癌肝转移（EBDCLM）的临床病理特征，确定预后危险因素，并评估其长期预后。
我们从 SEER 数据库中确定了 1922 例符合条件的 EBDCLM 患者。使用 Cox 回归模型预测总生存期（OS）和癌症特异性生存期（CSS）的独立预后因素，并绘制 Kaplan-Meier 生存曲线。根据多因素 Cox 分析的结果构建列线图，并评估列线图的预测效果。
年龄、手术、化疗、脑转移和肺转移是 OS 和 CSS 的常见独立预后因素，而放疗和骨转移是 CSS 的独立预后因素。Kaplan-Meier 生存曲线显示，年龄小于或等于 70 岁、接受手术和化疗且无肺转移的患者生存率显著提高。结果表明，我们构建的列线图具有良好的预测性，具有很强的临床应用价值。
本研究确定了年龄、手术、化疗、脑转移和肺转移是 EBDCLM 患者的独立预后因素。该列线图可以准确预测生存率，有助于临床医生评估晚期 EBDC 患者的预后，并为患者提供个性化的临床决策。
