| 1 | Prognostic factors and long-term outcomes of hilar cholangiocarcinoma:A single-institution experience in China显示文摘AIM: To evaluate the prognostic factors of hilar cholangiocarcinoma in a large series of patients in a single institution.METHODS: Eight hundred and fourteen patients with a diagnosis of hilar cholangiocarcinoma that were evaluated and treated between 1990 and 2014, of which 381 patients underwent curative surgery, were included in this study. Potential factors associated with overall survival(OS) and disease-free survival(DFS) were evaluated by univariate and multivariate analyses.RESULTS: Curative surgery provided the best long-term survival with a median OS of 26.3 mo. The median DFS was 18.1 mo. Multivariate analysis showed that patients with tumor size > 3 cm [hazard ratio(HR) = 1.482, 95%CI: 1.127-1.949; P = 0.005], positive nodal disease(HR = 1.701, 95%CI: 1.346-2.149; P < 0.001), poor differentiation(HR = 2.535, 95%CI: 1.839-3.493; P < 0.001), vascular invasion(HR = 1.542, 95%CI: 1.082-2.197; P = 0.017), and positive margins(HR = 1.798, 95%CI: 1.314-2.461; P < 0.001) had poor OS outcome. The independent factors for DFS were positive nodal disease(HR = 3.383, 95%CI: 2.633-4.348; P < 0.001), poor differentiation(HR = 2.774, 95%CI: 2.012-3.823; P < 0.001), vascular invasion(HR = 2.136, 95%CI: 1.658-3.236; P < 0.001), and positive margins(HR = 1.835, 95%CI: 1.256-2.679; P < 0.001). Multiple logistic regression analysis showed that caudate lobectomy [odds ratio(OR) = 9.771, 95%CI: 4.672-20.433; P < 0.001], tumor diameter(OR = 3.772, 95%CI: 1.914-7.434; P < 0.001), surgical procedures(OR = 10.236, 95%CI: 4.738-22.116; P < 0.001), American Joint Committee On Cancer T stage(OR = 2.010, 95%CI: 1.043-3.870; P = 0.037), and vascular invasion(OR = 2.278, 95%CI: 0.997-5.207; P = 0.051) were independently associated with tumorfree margin, and surgical procedures could indirectly affect survival outcome by influencing the tumor resection margin. CONCLUSION: Tumor margin, tumor differentiation, vascular invasion, and lymph node status were independent factors for OS and DFS. Surgical procedures can indirectly affect survival outcome by influencing the tumor resection margin. | Hai-Jie Hu Hui Mao Anuj Shrestha Yong-Qiong Tan Wen-Jie Ma Qin Yang Jun-Ke Wang Nan-Sheng Cheng Fu-Yu Li | 2016 | World Journal of Gastroenterology2016，22，8： | 40 |
| 2 | 联合肝切除术改善肝门部胆管癌术后长期生存的Meta分析显示文摘目的系统评价联合肝切除术能否改善肝门部胆管癌术后的长期生存。方法以肝门部胆管癌、肝门胆管癌、肝切除术、生存率为中文检索词,以hilar cholangiocarcinoma、perihilar cholangiocarcinoma、klatskin tumor、hepatectomy、liver resection、survival rate为英文检索词,计算机手工检索Pub Med数据库、Embase数据库、Cochrane图书馆数据库、中国知网(CNKI)、中国生物医学文献数据库(CBM)、中文科技期刊数据库(维普)、万方数字化期刊全文数据库中已发表的资料和会议论文;获得有关比较联合切肝和非切肝手术治疗肝门部胆管癌生存情况的文献。检索时间为建库至2015年1月。结果本Meta分析纳入文献10篇,共952例患者,其中切肝组625例,非切肝组327例。与非切肝组相比,切肝组术后1年生存率的比值比(OR值)[95%可信区间]为1.79[0.89~3.60],两组比较差异无统计学意义(P>0.05);术后2、3、5年生存率的OR值[95%可信区间]分别为3.45[2.06~5.79]、3.60[2.54~5.11]、5.66[3.30~9.72],两组术后2、3、5年生存率比较差异均有统计学意义(P均<0.01)。结论联合肝切除治疗HCCA能明显提高患者术后2~5年的生存率,改善患者的长期生存。 | 孙少甫 潘亚军 | 2015 | 山东医药2015，55，45： | 1 |
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