肝内胆管细胞癌预后因素分析

Prognostic analysis of patients suffering from intrahepatic cholangiocarcinoma

Objective:The outcome of surgical treatment of patients with intrahepatic cholangiocarcinoma (ICC) is poor.This study was designed to analyze prognostic factors after surgical procedure for ICCs.Methods:A retrospective clinical analysis was made in 183 cases of ICC,admitted to Department of Hepatic Surgery,Eastern Hepatobiliary Surgery Hospital,Second Military Medical University,Shanghai,China,from December 1996 to July 2003.Fifteen clinicopathologic factors that could possibly influence survival were selected.A multivariate analysis of these individuals was performed using the Cox Pro-portional Hazards Model.Results:The accumulative 1-,3- and 5-year survival rates of the patients were 51.3%,21.6% and 11.8% respectively.The statistical analysis showed that surgical procedure,lymph node metastasis,serum level of CA19-9 and pathological differentiation grade affected postoperative survival significantly,but transfusion,postoperative radiotherapy and chemotherapy,diameter of tumor,serum level of AFP,cirrhosis,preoperative total serum bilirubin level (TBIL),ratio of albumin to globulin (A/G),sex and age were not significant factors influencing postoperative survival.Conclusion:Major hepatectomy with systematic lymph node dissection may be recommended for the surgical treatment of ICC.Aggressive treat-ment and prevention on postoperative intrahepatic recurrence and lymph node metastasis are important strategy to improve the survival for ICC.