Jan Y Y, Jeng L B, Hwang T L, Wang C S, Chen M F, Chen T J
Department of Surgery, Chang Gung Memorial Hospital Chang Gung College of Medicine and Technology.
Hepatogastroenterology. 1996 May-Jun;43(9):614-9.
BACKGROUND/AIMS: Radical resection for patients with peripheral cholangiocarcinoma is rare. Prognostic factors related to survival with peripheral cholangiocarcinoma after hepatectomy have not yet been reported.
Of 41 hepatectomized patients with peripheral cholangiocarcinoma, a computer analysis of 14 clinicopathological factors on patients survival was performed with univariate and multivariate analysis.
Median and mean survival times for patients with peripheral cholangiocarcinoma after hepatectomy were 12.0 and 22.8 months. The 1-, 2-, 3-, 4- and 5-year survival rates were 53.7%, 39.0%, 36.6%, 26.8%, and 26.8% respectively. Univariate analysis of overall survival involving all patients identified 7 factors that were associated with a significantly outcome: mucobilia (p = 0.043), capsular invasion (p = 0.007), tumor spreading type (p = 0.0003), section margin (p = 0.001), histologic type (p = 0.008), macroscopic and microscopic vascular involvement (p = 0.031), and lymphatic invasion (p = 0.004). With multivariate analysis using the COX stepwise proportional hazards model, only mucobilia, tumor spreading type and section margin were significantly related to prognosis.
Intrahepatic bile duct carcinoma patients with mucobilia, intraductal papillomatosis and a tumor-free margin after hepatectomy had a better prognosis.
背景/目的：周围型胆管癌患者的根治性切除很少见。肝切除术后与周围型胆管癌生存相关的预后因素尚未见报道。
对41例行肝切除的周围型胆管癌患者，对14项临床病理因素进行计算机分析，采用单因素和多因素分析评估患者生存情况。
肝切除术后周围型胆管癌患者的中位生存时间和平均生存时间分别为12.0个月和22.8个月。1年、2年、3年、4年和5年生存率分别为53.7%、39.0%、36.6%、26.8%和26.8%。对所有患者的总生存进行单因素分析，确定了7个与显著预后相关的因素：黏液性胆汁（p = 0.043）、包膜侵犯（p = 0.007）、肿瘤扩散类型（p = 0.0003）、切缘（p = 0.001）、组织学类型（p = 0.008）、大体和镜下血管侵犯（p = 0.031）以及淋巴侵犯（p = 0.004）。使用COX逐步比例风险模型进行多因素分析，只有黏液性胆汁、肿瘤扩散类型和切缘与预后显著相关。
肝切除术后有黏液性胆汁、导管内乳头状瘤且切缘无肿瘤的肝内胆管癌患者预后较好。
