Analysis of prognosis after surgical treatment for extrahepatic cholangio-carcinoma
AIM: To investigate the effect of clinical features and the prognosis after surgical treatment for extrahepatic cholangio-carcinoma. METHODS: The clinical features, diagnosis, surgical therapy and follow-up result were retrospectively analyzed on 128 cases of EHCC admitted into our hospital from January 1995 to December 2003. A multivariate analysis was performed in these patients by the Cox proportional hazard model. RESULTS: Among 128 patients, 107 underwent surgical treatment (radical resection in 47, palliative resection in 12, nonresectional internal or external bile drainage in 45, and only laparatomy in 3), but 21 did not have surgery . The 1-, 3-, 5-year survival rates were 52.8% , 27.2% and 11.9% in the overall patients and were 72.4%, 44.7% and 22.7% in the radical resection group, respectively. The 1-, 2-, 3-year survival rates were 54.5%, 27.3% and 9.1% in palliative resection group, respectively, and none of the patient survived for over 5 years, whereas, in the nonresectional internal or external drainage group, 1-, 2-, 3-year survival rates were 32.1%, 17.2% and 8.6%, respectively, and none survived for over 4 years. There were significant differences in the survival rate among the radical resection group, the palliative resection group, nonresectional internal or external drainage group, and non-surgical treatment group(log-rank test, P ＜ 0.001). The univariate analysis showed that the major significant prognostic factors influencing survival of these patients were histological type of the lesion, TNM stages, lymph node metastasis, involvement of liver, pancreatic invasion, residual tumor margins, and therapeutic interventions (P ＜ 0.05). CONCLUSION: The radical resection improve the prognosis of EHCC. To improve the survival rate, more attention should be paid to early diagnosis and treatment. After curative resection, lymph node metastasis and residual tumor margins are independent prognostic factors for EHCC.
NETL
NSTL
万方数据
维普
