Prognostic factors of radical resection on patients with intrahepatic cholangiocarcinoma and impact of abdominal lymph node dissection on prognosis

Q4 Medicine

中华肝胆外科杂志 Pub Date : 2020-01-28 DOI:10.3760/CMA.J.ISSN.1007-8118.2020.01.011

Minghui Zhu, Xianzhou Zhang, Feng Han, Changfu Nie

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引用次数: 1

Abstract

Objective To study factors affecting prognosis of patients with intrahepatic cholangiocarcinoma (ICC), focusing on the correlation between extent of lymph node dissection and prognosis of patients with ICC. Methods The clinical data of ICC patients who underwent radical resection at the Hepatobiliary and Pancreatic Surgery of Affiliated Cancer Hospital of Zhengzhou University from October 2013 to October 2017 were retrospectively analyzed. According to the extent of lymph node dissection, the patients were divided into the non-dissected lymph node group, the routine dissection lymph node group and the extended lymph node dissection group. The prognoses of the three groups were compared. The Cox stepwise regression model was used to analyze the independent risk factors for prognosis of patients with ICC. Results The 178 patients included 109 males and 69 females. Their ages ranged from 30 to 81 years (average 59 years). There were 80 patients in the non-dissected group, 34 patients in the routine lymph node dissection group, and 64 patients in the extended lymph node dissection group. The overall survival rates of the 178 patients at 3 years after liver resection was 29.2%(52/178), overall median survival 25.8 months. The 3-year survival rates of the non-dissected group, routine dissection group, and extended dissection group were 10.0%(8/80), 52.9%(18/34), 40.6%(26/64), respectively. The differences among the three groups were significant (P 0.05). There was a significant difference in survival rates between the non-dissected group and the extended lymph node dissection group (P<0.05). Univariate analysis showed that CA19-9, tumor diameter, portal tumor thrombus, and lymph node dissection were related to prognosis of patients with ICC (P<0.05). Multivariate analysis showed CA19-9, tumor diameter, and extent of lymph nodes clearance were related to patient survival (P<0.05). Conclusions CA19-9, tumor diameter, and extent of lymph node dissection were independent risk factors of survival in patients with ICC. For patients with ICC who undergo surgical resection, conventional laparoscopic lymph node dissection can achieve good results, and there is no need to extend lymph node dissection. Key words: Cholangiocarcinoma; Lymph node excision; Prognosis analysis

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肝内胆管癌根治性切除的预后因素及腹腔淋巴结清扫对预后的影响

目的探讨影响肝内胆管癌(ICC)患者预后的因素，重点探讨淋巴结清扫程度与ICC患者预后的关系。方法回顾性分析2013年10月至2017年10月郑州大学附属肿瘤医院肝胆胰外科行根治性切除的ICC患者的临床资料。根据淋巴结清扫程度将患者分为未清扫淋巴结组、常规清扫淋巴结组和扩大淋巴结清扫组。比较三组患者的预后。采用Cox逐步回归模型分析影响ICC患者预后的独立危险因素。结果178例患者中男性109例，女性69例。年龄从30岁到81岁不等(平均59岁)。未清扫组80例，常规淋巴结清扫组34例，扩大淋巴结清扫组64例。178例患者肝切除术后3年总生存率为29.2%(52/178)，总中位生存期25.8个月。未清扫组、常规清扫组、扩大清扫组3年生存率分别为10.0%(8/80)、52.9%(18/34)、40.6%(26/64)。三组间差异均有统计学意义(p0.05)。未清扫组与淋巴结清扫组生存率比较，差异有统计学意义(P<0.05)。单因素分析显示，CA19-9、肿瘤直径、门静脉肿瘤血栓、淋巴结清扫与ICC患者预后相关(P<0.05)。多因素分析显示，CA19-9、肿瘤直径、淋巴结清扫程度与患者生存相关(P<0.05)。结论CA19-9、肿瘤直径、淋巴结清扫程度是影响ICC患者生存的独立危险因素。对于行手术切除的ICC患者，常规腹腔镜淋巴结清扫能达到较好的效果，不需要扩大淋巴结清扫。关键词:胆管癌;淋巴结切除;预后分析

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来源期刊

中华肝胆外科杂志 Medicine-Gastroenterology

CiteScore

0.20

自引率

0.00%

发文量

7101

期刊介绍： Chinese Journal of Hepatobiliary Surgery is an academic journal organized by the Chinese Medical Association and supervised by the China Association for Science and Technology, founded in 1995. The journal has the following columns: review, hot spotlight, academic thinking, thesis, experimental research, short thesis, case report, synthesis, etc. The journal has been recognized by Beida Journal (Chinese Journal of Humanities and Social Sciences). Chinese Journal of Hepatobiliary Surgery has been included in famous databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences), CSCD Source Journals of China Science Citation Database (with Extended Version) and so on, and it is one of the national key academic journals under the supervision of China Association for Science and Technology.