Research on Related Factors for Prognosis in Patients with Cholangiocarcinoma_West China Medical Journal

Authors：

 MAOZhi-yuan ^1,2 , GUOXiao-chuan ¹ , ZHANGTing-ting ¹ , SUDan ¹ , WANGLi-jie ¹ ,  BAILi ¹

1. Department of Oncology, PLA General Hospital, Beijing 100853, P. R. China;
2. Department of Oncology, PLA Air Force General Hospital, Beijing 100142, P. R. Chinav;

Corresponding author：

BAILi, Email: baili0795@126.com

Keywords：

Cholangiocarcinoma; Prognosis; Cox analysis

DOI：

10.7507/1002-0179.20140618

Video：

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Objective To review and summarize the clinical data and survival information of patients with cholangiocarcinoma treated by surgery, and to explore the clinical and pathological features of cholangiocarcinoma, and the relationship between intraoperative and postoperative characteristics and prognosis. Methods We retrospectively analyzed the clinical data of 678 cholangiocarcinoma patients after operation in the PLA General Hospital from January 2004 to December 2010, including the follow-up results of 397 cases. Only 293 patients with surgical resection of cholangiocarcinoma and non-surgical reasons for death were analyzed using Cox proportional hazards model. All indicators were analyzed by univariate and multivariate analysis. Results The median follow-up time was 55.9 months. As of the end of follow-up, there were 158 cases of recurrence (53.9%) and 223 cases of death (76.1%). The median overall survival time was 21.2 months, and 1-year, 3-year and 5-year survival rates were 71.7%, 38.2% and 10.6%, respectively. Tumor differentiation, TNM stage, surgical margin, intraoperative blood transfusion, tumor location, alkaline phosphatase levels in blood and recurrence were independent risk factors for overall survival time. Conclusion Low degree of tumor differentiation, advanced TNM stage, cancer invasion on the surgical margin, intraoperative blood transfusion, tumor located outside the liver, alkaline phosphatase levels in blood higher than normal, and cholangiocarcinoma tumor recurrence are risk factors for overall survival rate in patients with cholangiocarcinoma.

Citation： MAOZhi-yuan, GUOXiao-chuan, ZHANGTing-ting, SUDan, WANGLi-jie, BAILi. Research on Related Factors for Prognosis in Patients with Cholangiocarcinoma. West China Medical Journal, 2014, 29(11): 2046-2049. doi: 10.7507/1002-0179.20140618 Copy

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1. 王健东, 全志伟. 胆管癌基础研究现状[J]. 中国实用外科杂志, 2008, 28(4):297-300.
2. Hezel AF, Zhu AX. Systemic therapy for biliary tract cancers[J]. Oncologist, 2008, 13(4):415-423.
3. Ebata T, Nagino M, Kamiya J, et al. Hepatectomy with portal vein resection for hilar cholangiocarcinoma:audit of 52 consecutive cases[J]. Ann Surg, 2003, 238(5):720-727.
4. Rea DJ, Munoz-Juarez M, Farnell MB, et al. Major hepatic resection for hilar cholangiocarcinoma:analysis of 46 patients[J]. Arch Surg, 2004, 139(5):514-523.
5. 陈中, 晏建军, 黄亮, 等. 肝内胆管细胞癌预后因素分析[J]. 中华肝胆外科杂志, 2006, 12(10):654-656.
6. 陶连元, 何小东, 高飞, 等. 肝外胆管癌的临床病理与预后分析[J]. 肝胆外科杂志, 2011, 19(4):251-253.
7. 董娜娜, 段晓峰, 张倜, 等. 103例肝内胆管癌临床病理及诊治分析[J]. 中国肿瘤临床, 2012, 39(6):340-342, 347.
8. 陆凯, 张博, 董立巍, 等. 中下段胆管癌的预后影响因素分析[J]. 现代生物医学进展, 2012, 12(26):5068-5071.
9. 张佳, 吴硕东, 孔静. 肝内胆管细胞癌的早期诊断[J]. 临床误诊误治, 2010, 23(增刊1):49-49.
10. Khan SA, Davidson BR, Gold IR, et al. Guide lines for the diagnosis and treatment of cholangiocarcinoma:consensus document[J]. Gut, 2002, 51(Suppl 6):s7-s9.
11. Ribero D, Amisano M, Lo Tesoriere R, et al. Additional resection of an intraoperative margin-positive proximal bile duct improves survival in patients with hilar cholangiocarcinoma[J]. Ann Surg, 2011, 254(5):776-781.
12. 陆凯. 不同部位胆管癌的临床病理特征与预后关系分析[D]. 上海:第二军医大学, 2007:1-55.
13. De Jong MC, Nathan H, Sotiropoulos GC, et al. Intrahepatic cholangiocarcinoma:an international multi-institutional analysis of prognostic factors and lymph node assessment[J]. J Clin Oncol, 2011, 29(23):3140-3145.
14. Shiba H, Ishida Y, Wakiyama S, et al. Negative impact of blood transfusion on recurrence and prognosis of hepatocellular carcinoma after hepatic resection[J]. J Gastrointest Surg, 2009, 13(9):1636-1642.
15. 石俊方, 杨椿. 输血对恶性肿瘤手术预后的影响[J]. 中国肿瘤临床, 1991, 18(增刊1):318-319.
16. 李书红, 王俊, 张金野, 等. 手术切除肝内胆管细胞癌预后相关因素分析[J]. 中华肿瘤防治杂志, 2011, 18(24):1956-1959.
17. 张梅英, 温志立, 许艳华. ALP、γ-GT和CHE检测在慢性乙型肝炎、肝硬化、肝癌、胆道疾病中的临床意义[J]. 南昌大学学报·医学版, 2012, 52(2):34-36.

West China Medical Journal

Research on Related Factors for Prognosis in Patients with Cholangiocarcinoma

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