论文部分内容阅读
背景虽然肝内胆管细胞癌(ICC)的发病率在持续增加,但它仍然是一种少见的肿瘤。手术切除是主要治疗手段,而目前关于预后因素和适合手术的病例选择的参考数据相对缺乏,我们决定对可切除ICC患者的临床病理特征和手术治疗的预后因素进行分析。方法 收集患者信息、病理和手术操作等临床资料,用Cox风险模型和Kaplan-Meier法分析生存率和复发率。结果 共收集到31例接受手术治疗的患者,3年总体生存率为40.1%,中位生存率为16.2月(0.2~86.9月)。与R1/R2切除相比,R0切除可显著提高3年生存率(3年生存率:R0:68.6%R1/R2:24.0%)。术后并发症发生率为58.1%。2例于术后30天死于肝衰竭,术前低白蛋白血症与术后低生存率显著相关。结论 手术切除治疗ICC可使患者获得更长的生存期,特别是营养状况良好的患者,甚至可达到R0切除。但扩大的切除手术将显著增加手术死亡率。所以手术者在制定手术计划时应考虑到此疾病的高切缘阳性率和浸润性疾病本质等因素。
Background Although the incidence of intrahepatic cholangiocarcinoma (ICC) continues to increase, it remains a rare tumor. Surgical resection is the primary treatment. However, the current lack of reference data on the prognostic factors and the selection of suitable surgical cases, we decided to analyze the clinicopathological characteristics of resectable ICC patients and the prognostic factors of surgical treatment. Methods The clinical data such as patient information, pathology and surgical operation were collected. The survival rate and recurrence rate were analyzed by Cox risk model and Kaplan-Meier method. Results A total of 31 patients undergoing surgical treatment were collected. The 3-year overall survival rate was 40.1% and the median survival rate was 16.2 months (0.2-2.8.9 months). Compared with R1 / R2 resection, R0 resection can significantly improve 3-year survival rate (3-year survival rate: R0: 68.6% R1 / R2: 24.0%). The incidence of postoperative complications was 58.1%. Two patients died of liver failure 30 days after operation. Preoperative hypoalbuminemia was significantly associated with low postoperative survival rate. Conclusion Surgical resection of ICC patients can achieve longer survival, especially in patients with good nutritional status, and even achieve R0 resection. However, an enlarged resection will significantly increase the operative mortality. Therefore, the surgeon in the development of surgical plans should take into account the high positive margins of the disease and the nature of invasive disease and other factors.