摘要
目的探讨影响肝门部胆管癌(hilar cholangiocarcinoma,HCC)术后实际5年生存率的临床及病理因素。方法收集2000年1月到2015年6月在宁波市医疗中心李惠利医院肝胆胰外科接受HCC根治术的患者94例,分为存活超过5年组和未存活到5年组,比较两组患者临床及病理特点差别。结果94例患者中19例(20.2%)术后生存期超过5年,HCC的实际5年总生存率(20.2%)低于Kaplan-Meier生存分析估算的5年生存率(22.2%)。两组患者的基线资料、术中资料差异均无统计学意义(P<0.05);病理资料中,两组的病理类型(P=0.012)、淋巴结转移(P=0.001)、切除水平(P=0.048)差异有统计学意义。结论病理类型非乳头型、淋巴结转移、R1切除是影响HCC术后实际5年生存率的危险因素。
Objective To evaluate clinical and pathological factors related to the actual 5-year survival of patients with hilar cholangiocarcinoma(HCC).Methods A total of 94 HCC patients who underwent radical surgery at the Department of Hepatobiliary and Pancreatic Surgery,Li Huili Hospital of Ningbo Medical Center from Jan 2000 to Jun 2015 were enrolled in this study.Patients were divided into two groups:postoperative survival group beyond 5 years and death group within 5 years.The clinical and pathological features of the two groups were analyzed.Results Of the 94 patients,19(20.2%)had a postoperative survival time of more than 5 years.The actual 5-year overall survival rate of HCC patients(20.2%)was lower than that estimated by Kaplan-Meier survival analysis(22.2%).Gender,age,CEA value,CA199 value,total bilirubin,Child-Pugh classification,Bismuth classification and preoperative jaundice reduction were not significantly different between the two groups nor there were significant difference between two groups in operation time,blood loss,surgical procedure,combined caudate lobectomy,combined pancreaticoduodenectomy,combined resection of surrounding organs,vascular reconstruction and number of bile duct orifices in remnant liver surface.There were significant differences between two groups in the variables of pathological phenotype(P=0.012),lymph node metastasis(P=0.001)and resection level(P=0.048).Conclusion Non-papillary type,lymph node metastasis and R1 resection are the independent risk factors of the actual 5-year survival.
作者
陆树葳
陆才德
宓宏潮
杨勇
朱宏达
房炯泽
Lu Shuwei;Lu Caide;Mi Hongchao;Yang Yong;Zhu Hongda;Fang Jiongze(Department of Hepatopancreatobiliary Surgery,Ningbo Medical Centre Lihuili Hospital,Ningbo University,Zhejiang Province 315040,China)
出处
《中华普通外科杂志》
CSCD
北大核心
2021年第11期809-816,共8页
Chinese Journal of General Surgery
基金
浙江省医药卫生科技计划项目(2020KY865)。
关键词
胆道肿瘤
外科手术
5年生存率
病理
预后
Bile duct neoplasms
Surgical procedures,operative
5-year survival
Pathology
Prognosis
