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| 1 | Survival analysis of cholangiocarcinoma:A 10-year experience in Malaysia显示文摘AIM:To investigate the clinical features and survival of patients treated for cholangiocarcinoma in our institution and to analyze the factors affecting their survival.METHODS:This retrospective cohort study assessed patients diagnosed with cholangiocarcinoma between January 1997 and December 2007 at the University Malaya Medical Centre in Malaysia.The clinical data and associated outcomes were collected using a structured proforma.RESULTS:Of the 69 patients diagnosed with cholangiocarcinoma,38 (55%) were male;mean patient age was 61 years.Twelve patients (17%) had intrahepatic,38 (55%) had perihilar and 19 (28%) had distal tumors.Only 12 patients underwent curative surgery,including seven R0 resections.Only one patient died within 30 d after surgery.The overall median survival was 4 mo,whereas the median survival of R0 resected patients was 16 mo.The overall 1-,2-and 3-year cumulative survival rates were 67%,17% and 17%,respectively.Survival rates were significantly associated with curative resection (P=0.002),intrahepatic tumor (P=0.003),negative margin status (P=0.013),early tumor stage (P=0.016),higher tumor differentiation (P=0.032) and absence of jaundice (P=0.038).Multivariate analysis showed that tumor location was a significant independent predictor of patient survival.CONCLUSION:Curative,margin-negative resection of early stage,well-differentiated intrahepatic tumors is associated with improved patient survival. | Ahmad Ramzi Yusoff Mohd Muzammil Abdul Razak Yoong Boon Koon R Vijeyasingam Siti Zuraidah Mahmud | 2012 | World Journal of Gastroenterology2012，18，5： | 7 |
| 2 | Comorbidity negatively influences prognosis in patients with extrahepatic cholangiocarcinoma显示文摘AIM:To study the outcome and prognostic factors in a series of patients with extrahepatic cholangiocarcinoma and determine the impact of comorbidity on survival.METHODS:A retrospective analysis of 68 patients with extrahepatic cholangiocarcinoma(perihilar,n = 37;distal,n = 31) seen at a single tertiary-care institution during the period 1999-2003 was performed.Data on presentation,management,and outcome were assessed by chart review.Pathologic confirmation was obtained in 37 cases(54.4%) .Comorbidity was evaluated by using the Charlson comorbidity index(CCI) .RESULTS:Mean age at diagnosis was 73.4 ± 11.5 years.Jaundice was the most common symptom presented(86.8%) .Median CCI score was 1(range,0 to 4) .Nineteen patients(27.9%) underwent tumor resection.Palliative biliary drainage was performed in 39 patients(57.4%) ,and 6 patients(8.8%) received only best supportive care.Tumor-free margin status(R0) was achieved in 15 cases(78.9% of resection group) .Baseline serum carbohydrate antigen 19-9(CA 19-9) level was revealed to be an independent predictor of surgical treatment(P = 0.026) .Overall median survival was 3.1 ± 0.9 mo,with 1-and 2-year survival rates of 21% and 7%,respectively.In the univariate analysis,tumor resection,CCI score,and serum CA 19-9 levels correlated significantly with outcome.In the multivariate analysis,only resection(HR 0.10;95% CI,0.02-0.51,P = 0.005) and a CCI score ≥ 2(HR 3.36;95% CI,1.0-10.9,P = 0.045) were found to independently predict survival.CONCLUSION:Tumor resection and comorbidity emerged as significant prognostic variables in extrahepatic cholangiocarcinoma.Comorbidity evaluation instruments should be applied in the clinical management of such patients. | Mario Fernández-Ruiz Juan-Manuel Guerra-Vales Francisco Colina-Ruizdelgado | 2009 | World Journal of Gastroenterology2009，15，42： | 3 |
| 3 | 影响老年人肝内胆管细胞癌手术预后的因素分析显示文摘目的探讨老年肝内胆管细胞癌手术治疗预后相关因素,提高其诊断和治疗水平。方法回顾性对比分析我院1988年10月至2007年10月手术治疗的老年(≥65岁)肝内胆管细胞癌36例与非老年(<65岁)肝内胆管细胞癌32例的临床资料。采用Kaplan-Meier法统计术后生存期并进行单因素分析,Cox回归法进行多因素分析。结果老年组行根治性切除者1、3、5年生存率与行姑息性切除者相较,差异有统计学意义(P<0.01);CEA>10μg/L者1、3、5年生存率与≤10μg/L者相较差异有统计学意义(P<0.01)。多因素分析根治性切除术、CEA是术后生存的独立影响因素。结论老年人肝内胆管细胞癌以手术治疗为主,CEA水平和根治性切除术是影响其预后的主要因素。 | 万春 陈孝平 赵玉亭 | 2009 | 腹部外科2009，22，4： | 1 |
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