Clinical and survival outcomes of percutaneous microwave ablation for intrahepatic cholangiocarcinoma

Objective: To evaluate the outcomes of percutaneous microwave ablation (MWA) and explore the prognostic factors for the survival of patients with intrahepatic cholangiocarcinoma (ICC).

Methods: A total of 107 patients (age: mean 58.0?years, range 15–85?years) with 171 ICCs (maximum size ≤5?cm, tumour number per patient ≤3) who underwent MWA for ICC during January 2009 to February 2016 were selected, and their clinical and pathological data were collected and reviewed. The MWA-associated mortality, major complication rate and survival were evaluated. The prognostic factors for survival in patients with ICC were analysed with univariate and multivariate analyses.

Results: The median follow-up after MWA was 20.1?months (2.8–63.5?months). There was no procedure-associated death. The overall procedure-associated major complication rate was 2.8%. The median PFS after MWA was 8.9?months; PFS rates after 6, 12, 18 and 24?months were 67.4%, 41.5%, 18.2% and 8.7%. The median OS was 28.0?months; OS rates after 1, 3 and 5?years were 93.5%, 39.6% and 7.9%. Child-Pugh class A and less tumour number were identified as factors predictive of prolonged PFS (HR for Child–Pugh class: 2.62, p?=?0.001; HR for tumour number: 2.07, p?=?0.002) and OS (HR for Child–Pugh class: 4.14, p?p?=?0.024).

Conclusions: Percutaneous ultrasound-guided MWA is safe and effective for ICC. Child–Pugh class A and less tumour number predict prolonged PFS and OS in patients with ICC treated by MWA.     

Ultrasound-guided percutaneous microwave ablation vs. surgical resection for thoracoabdominal wall implants from hepatocellular carcinoma: intermediate-term results

Objective: The aims of this study were to compare the clinical outcomes between ultrasound (US)-guided percutaneous microwave ablation (MWA) and surgical resection (SR) in patients with thoracoabdominal wall implants from hepatocellular carcinom (HCC) and to identify the prognostic factors associated with the two treatment methods.

Materials and methods: A total of 47 patients (mean age, 56.7?±?15.9 years, range, 18–78 years; 34 men and 13 women) with 61 thoracoabdominal wall HCC seeding were included from April 2007 to May 2017. Twenty-five patients underwent US-guided MWA and 22 patients underwent SR. Survival, recurrence and liver function were compared between the two groups. Effect of changes in key parameters (i.e. overall survival (OS), disease-free survival (DFS) and local tumour reoccurrence-free (LTRF)) was statistically analysed with the log-rank test. Univariate and multivariate analyses were performed on several clinicopathological variables to identify factors affecting long-term outcome and recurrence.

Results: The OS, DFS and LTRF after MWA were comparable to those of SR (p?=0.493, p?=?0.578 and p?=0.270, respectively). Estimated 5-year overall survival rates were 63% after MWA and 48.1% after SR; for disease-free survival, estimated 5-year rates were 67.5% after MWA and 48.8% after SR; estimated 24-month LTRF rates were 71.3% after MWA and 87.8% after SR. The MWA group had less surgical time (p?=?<0.001), estimated blood loss (p =?<0.001) and post-operative hospitalisation (p?=?0.032) and cost (p?=?0.015). Multivariate analysis showed remnant intrahepatic tumour (p?=0.007), Child Pugh grade (p?=?0.009) and metastasis (p=?<0.001), were predictors for survival rate.

Conclusions: Ultrasound-guided percutaneous MWA is a safe and effective treatment method for metastatic HCC on the thoracoabdominal wall with similar outcomes to SR. Residual intrahepatic HCC, Child Pugh grade and distant metastasis are predictors for survival.     

Predictive value of the albumin-bilirubin grade on long-term outcomes of CT-guided percutaneous microwave ablation in intrahepatic cholangiocarcinoma

Purpose: To assess the efficacy of the albumin-bilirubin (ALBI) grade on assessing long-term outcomes of computed tomography (CT)-guided percutaneous microwave ablation (CT-PMWA) in the treatment of patients with intrahepatic cholangiocarcinoma (ICC).

Methods: Between April 2011 and March 2018, 78 patients who underwent CT-PMWA were enrolled in this study. Overall survival (OS) and recurrence-free survival (RFS) were compared in the groups stratified by the ALBI grade and Child–Pugh score. Cox proportional hazard regression analyses were performed to determine independent predictors of OS and RFS.

Results: After a median follow-up of 22.7?months (range 1–86.7?months), 67 patients had died. The cumulative 1-, 3-, and 5-year OS rates were 89.5%, 52.2%, and 35.0%, respectively. Stratified by the ALBI grade, the cumulative 1-, 3-, and 5-year OS rates were 100%, 69.2%, and 25.6% for patients with the grade 1, respectively. For patients with the ALBI grade 2, the cumulative 1-, 3-, and 5-year OS rates were 41.0%, 10.3%, and 10.3%, respectively. Patients with a hepatic function of the ALBI grade 1 had significantly higher OS rates than patients with the ALBI grade 2 (p?<?.001). The multivariate analysis showed tumor size (Hazard Ratio[HR] 95% Confidence Interval[CI]:9.03[1.01–80.52], p?=?.049) and the ALBI grade (HR[95%CI]:9.56[1.58–58.00], p?=?.014) were associated with OS, and tumor size (HR: 2.03[0.69–8.04], p?=?.049) was associated with RFS.

Conclusions: The preliminary data of this study showed the ALBI grade was effective to predict long-term outcomes of CT-PMWA in ICCs. Further study is necessary to validate our results by a large, multi-center patient cohort.     

Ultrasound-guided percutaneous microwave ablation of adrenal metastasis: Preliminary results

Purpose: To evaluate the feasibility, safety and therapeutic effects of ultrasound (US)-guided percutaneous microwave (MW) ablation in the treatment of adrenal metastasis.

Materials and methods: From May 2006 to April 2008, five consecutive patients with pathologically proven unilateral adrenal metastases with a diameter of 2.3 to 4.5 cm were treated by US-guided percutaneous MW ablation. Four metastases were in the right side, one metastasis was in the left side. For each application, two cooled-shaft needle antennae were percutaneously inserted into the tumour under real-time US guidance. One thermocouple needle was inserted at the periphery of the tumour to monitor temperature in real-time during MW ablation. MW emission was ended when the entire tumour became hyperechoic and the temperature at the tumour border reached 54°C for at least 3 min. Technical success was defined as loss of tumour enhancement on contrast-enhanced imagings.

Results: All adrenal metastases were completely ablated after scheduled MW ablation sessions (mean, 1.2 sessions, range, 1 to 2 sessions). No major complications related to MW ablation occurred. In a median follow-up of 19 months (range 8 to 31 months), persistent absence of tumour enhancement was observed in the treated tumour in all patients.

Conclusions: US-guided percutaneous MW ablation appears to be a safe and effective therapy in selected adrenal metastasis.     

Radiofrequency ablation for postoperative recurrences of intrahepatic cholangiocarcinoma

Objective: Most recurrent intrahepatic cholangiocarcinoma (RICC) lost the opportunity of radical resection while most nonsurgical management failed to prolong patients' survival. The efficacy and safety of radiofrequency ablation (RFA) as a local treatment for recurrent hepatocellular carcinoma have been confirmed by many clinical studies. The purpose of this study was to evaluate the efficacy, long-term survival and complications of RFA for RICC. Methods: A total of 12 patients with 19 RICCs after radical ...     

Ultrasound-guided percutaneous microwave ablation for symptomatic uterine fibroid treatment – A clinical study

Objective: The aim of this study was to assess the feasibility, safety and therapeutic effects of ultrasound (US)-guided percutaneous microwave thermal ablation (PMTA) in situ for the treatment of symptomatic uterine fibroid.

Materials and methods: The microwave (MW) antenna was percutaneously inserted into the fibroid under US guidance to perform the ablation. The ultrasound images, any complications and side effects were assessed during and after ablation. The shrinkage rate of the fibroid was calculated after the treatment.

Results: Forty patients underwent the treatment. The baseline fibroid volume was 14.6 to 341.1 cm³ (mean 140.1?±?87.4 cm³). When the MW therapy started, a heightened echo around the MW emission aperture of the antenna was observed and gradually propagated throughout the fibroid while the ablation continued. The mean ablation time was 490 s. Contrast enhanced MRI showed no enhancement in the fibroid post-ablation. The shrinkage rate of the fibroid was 61.8%, 78.7%, 73.2% and 93.1% at 3, 6, 9, and 12 months after ablation, respectively. Six patients felt pain in their lower abdomens or waists within 12 hours post-ablation, and the discomfort rapidly disappeared. Seven patients had a small amount of vaginal bloody secretions within one to two weeks after treatment, and six of these patients recovered from the bleeding without any therapy after one week. No patient developed complications and fever during or after the ablation.

Conclusions: PMTA for fibroid is feasible and safe, and it is an easy and fast procedure that is minimally invasive.     

Ultrasound-guided percutaneous microwave ablation for hepatic malignancy adjacent to the gallbladder

Abstract

Purpose: The study was performed to assess the safety and efficacy of ultrasound (US)-guided percutaneous microwave (MW) ablation for hepatic malignancy adjacent to the gallbladder. Materials and methods: From January 2011 to December 2013, 49 patients with 51 hepatic tumours adjacent to the gallbladder who underwent US-guided percutaneous MW ablation were included in the study group. A total of 106 patients with 117 hepatic tumours not adjacent to the gallbladder who underwent US-guided percutaneous MW ablation were included in the control group. In the study group the temperature of marginal ablation tissue proximal to the gallbladder was monitored and controlled at 45–54?°C for 5–10?min during the ablation. Ethanol (4.5–13?mL) was injected into the marginal tissue in 27 of 51 tumours of the study group. We compared the results of ablation between the two groups. Results: All patients were successfully treated. A total of 47 of 51 tumours in the study group (92.2%) and 110 of 117 tumours in the control group (94.0%) achieved complete ablation (p?=?0.93). Local tumour progression was found in nine (17.6%) tumours in the study group and 15 (12.8%) tumours in the control group during follow-up after MW ablation (p?=?0.41). No peri-procedural major complications occurred in either group. Conclusions: Under strict temperature monitoring, US-guided percutaneous MW ablation assisted with ethanol injection appears to be safe and can achieve a high rate of complete ablation for the treatment of hepatic malignant tumours adjacent to the gallbladder.     

Outcomes of vascular resection associated with curative intent hepatectomy for intrahepatic cholangiocarcinoma

Background and aimsWe aimed to investigate the impact of vascular resection (VR) on postoperative outcomes and survival of patients undergoing hepatectomy for intrahepatic cholangiocarcinoma (ICC).MethodsA retrospective analysis of a multi-institutional series of 270 patients with resected ICC was carried out. Patients were divided into three groups: portal vein VR (PVR), inferior vena cava VR (CVR) and no VR (NVR). Univariate and multivariate analysis were applied to define the impact of VR on postoperative outcomes and survival.ResultsThirty-one patients (11.5%) underwent VR: 15 (5.6%) to PVR and 16 (5.9%) to CVR. R0 resection rates were 73.6% in NVR, 73.3% of PVR and 68.8% in CVR. The postoperative mortality rate was increased in VR groups: 2.5% in NVR, 6.7% in PVR and 12.5% in CVR. The 5-years overall survival (OS) rates progressively decreased from 38.4% in NVR, to 30.1% in CVR and to 22.2% in PVR, p = 0.030. However, multivariable analysis did not confirm an association between VR and prognosis. The following prognostic factors were identified: size ≥50 mm, patterns of distribution of hepatic nodules (single, satellites or multifocal), lymph-node metastases (N1) and R1 resections. In the VR group the 5-years OS rate in patients without lymph-node metastases undergoing R0 resection (VRR0N0) was 44.4%, while in N1 patients undergoing R1 resection was 20% (p < 0.001).ConclusionVascular resection (PVR and CVR) is associated with higher operative risk, but seems to be justified by the good survival results, especially in patients without other negative prognostic factors (R0N0 resections).     

Prognostic influence of multiple hepatic lesions in resectable intrahepatic cholangiocarcinoma: A systematic review and meta-analysis

BackgroundPresence of multiple hepatic lesions in intrahepatic cholangiocarcinoma (iCCA) is included in staging as a negative prognostic factor, but both prognostic value and therapeutic implications remain debated. The aim of this study was to systematically review the prognostic influence of multiple lesions on survival after resection for iCCA, with stratification for distribution and number of lesions.MethodsMedline and Embase were systematically searched to identify records (2010–2021) reporting survival for patients undergoing primary resection for iCCA. Included were original articles reporting overall survival, with data on multiple lesions including tumour distribution (satellites/other multiple lesions) and/or number. For meta-analysis, the random effects model and inverse variance method were used. PRISMA 2020 guidelines were followed.ResultsThirty-one studies were included for review. For meta-analysis, nine studies reporting data on the prognostic influence of satellite lesions (2737 patients) and six studies reporting data on multiple lesions other than satellites (1589 patients) were included. Satellite lesions (hazard ratio 1.89, 95% confidence interval 1.67–2.13) and multiple lesions other than satellites (hazard ratio 2.41, 95% confidence interval 1.72–3.37) were significant negative prognostic factors. Data stratified for tumour number, while limited, indicated increased risk per additional lesion.ConclusionSatellite lesions, as well as multiple lesions other than satellites, was a negative prognostic factor in resectable iCCA. Considering the prognostic impact, both tumour distribution and number of lesions should be evaluated together with other risk factors to allow risk stratification for iCCA patients with multiple lesions, rather than precluding resection for the entire patient group.     

淋巴结转移对肝内胆管细胞癌患者预后的影响及临床相关因素研究

背景与目的：肝内胆管细胞癌（intrahepatic cholangiocarcinoma,ICC）是原发性肝癌中第二常见的病理学类型,起病隐匿,预后不佳。ICC常出现淋巴结转移（lymph node metastasis,LNM）。探讨肝十二指肠LNM与ICC患者临床相关因素及预后的关系。方法：共招募322例ICC患者在复旦大学附属中山医院行根治性肝肿瘤切除术,分析肝十二指肠LNM与临床病理学特征的关系及预后价值。结果：LNM与乙型肝炎病毒（hepatitis B virus,HBV）阳性、血清CA19-9>89 U/mL、肿瘤数目、肿瘤直径（>5 cm）、微血管侵犯、TNM分期、中性粒细胞/淋巴细胞比值（neutrophil-to-lymphocyte ratio,NLR）显著相关。Kaplan-Meier分析显示,无LNM的ICC患者组的1、3和5年总生存率（overall survival,OS）分别为80.8%、53.4%和40.3%,显著高于伴有LNM组（47.4%、20.4%和10.2%,P<0.001）。无LNM的ICC患者组的1、3和5年无瘤生存率（recurrence-free survival,RFS）分别为62.6%、43.4%和36.3%,显著高于伴有LNM组（25.6%、16.6%和12.4%,P<0.001）。进一步研究发现,血清CA19-9>89 U/mL（P<0.001）、肿瘤直径>5 cm（P=0.042）、肿瘤数目（P<0.001）、微血管侵犯（P=0.022）、TNM分期（P<0.001）、NLR≥2.49（P=0.016）、淋巴细胞/单核细胞比值（lymphocyte-to-monocyte ratio,LMR）<4.45（P=0.048）及LNM（P<0.001）与ICC患者术后无瘤生存时间（time to recurrence,TTR）显著相关;血清CA19-9>89 U/mL（P<0.001）、肿瘤直径>5 cm（P=0.008）、肿瘤数目（P=0.002）、TNM分期（P<0.001）、NLR≥2.49（P<0.001）、LMR<4.45（P=0.002）及LNM（P<0.001）与ICC患者术后OS显著相关。多因素分析显示,血清CA19-9>89 U/mL、肿瘤数目、LNM是影响ICC患者术后TTR的独立预后因素;血清CA19-9>89 U/mL、肿瘤数目、LMR<4.45、LNM是影响ICC患者术后OS的独立预后因素。结论：肝十二指肠LNM是ICC患者术后的独立预后因素,准确判断LNM状态具有重要的临床意义。     

CT-guided percutaneous microwave ablation of adrenal malignant carcinoma: preliminary results

BACKGROUND:

Microwave ablation has recently been developed as a safe and effective treatment for a variety of tumors. The authors evaluated the safety and efficacy of computed tomography (CT)‐guided percutaneous microwave ablation of adrenal malignant tumors.

METHODS:

Nine patients between 41 and 83 years of age (average age, 54 years) with adrenal carcinoma (a total of 10 lesions) received CT‐guided percutaneous water‐cooled microwave ablation. The 9 cases included 1 primary adrenocortical carcinoma and 8 metastatic carcinomas (4 from lung cancer, 2 from hepatocellular carcinoma, 1 from intrahepatic cholangiocarcinoma, and 1 from left tibial osteosarcoma). Of the 8 metastatic cases, 7 were unilateral, and 1 was bilateral. All cases were pathologically confirmed by aspiration biopsy or postsurgical biopsy. The tumor diameters ranged from 2.1 cm to 6.1 cm (average, 3.8 cm). The average number of ablation sites was 1.5 sites (1‐3 sites), and the average accumulated ablation time was 7.7 minutes (4‐15 minutes). The procedures were performed using a cooled‐shaft antenna.

RESULTS:

The patients were followed for 3‐37 months, with an average of 11.3 months. Nine of 10 lesions were completely necrotized after first treatment. The other lesion was completely necrotized after 2 treatments. One of the patients experienced hypertensive crisis during treatment. No patient experienced recurrent tumor at the treated site, and this lack of recurrence indicated effective local control. All patients had progression of metastatic disease at extra‐adrenal sites.

CONCLUSIONS:

CT‐guided percutaneous water‐cooled microwave ablation is a minimally invasive and effective method for the treatment of adrenal carcinoma. Cancer 2011;. © 2011 American Cancer Society.     

肝内胆管细胞癌微创治疗现状及进展#br#

肝内胆管细胞癌(ICC)是一类高侵袭性的恶性肿瘤,远期预后差,手术切除仍是其主要的治疗手段。目前,包括腹腔镜、机器人等在内的微创治疗已越来越广泛地应用于各类患者,其中相当部分是肿瘤患者。近几年国内外部分学者开始尝试应用微创手段治疗ICC患者,但关于其适应证选择及远期疗效尚存争议。该文就腹腔镜、机器人、热消融治疗ICC的研究现状及进展进行了论述。     

Impact of systemic inflammation on outcome following resection for intrahepatic cholangiocarcinoma

AIMS: To analyse the results and prognostic factors affecting disease-free and overall survival following potentially curative resection for intrahepatic cholangiocarcinoma (IHCC). METHODS: Patients undergoing resection for IHCC from January 1996 to December 2006 were included. Data analysed included demographics, clinical and histopathology data. RESULTS: Twenty-seven patients were identified with a median age of 57 (32-84) years. The 1-, 3- and 5-year overall and disease-free survival rates were 74%, 16% and 16%, and 44%, 15% and 15%, respectively. On univariate analysis, age <65 years, female gender, neutrophil to lymphocyte ratio (NLR) >or= 5, micro-vascular invasion and lymph node involvement were predictors of poorer overall survival. Multivariate analysis did not identify any independent predictors of overall survival. A NLR >or= 5 was the only adverse predictor of disease-free survival. The median disease-free survival of patients with NLR >or= 5 was 6 months compared to 18 months for those with NLR < 5. There was a significant association between patients with a NLR >or= 5 and larger tumour size, satellite lesions, micro-vascular invasion and lymph node involvement. CONCLUSION: Long-term outcome following resection of IHCC is poor. A pre-operative NLR >or= 5 was an adverse predictor of disease-free survival and was associated with an aggressive tumour biology profile.     

早期肝细胞癌射频消融联合肝动脉化疗栓塞与手术切除疗效Meta分析

目的通过Meta分析比较射频消融(radiofrequency ablation,RFA)联合肝动脉栓塞化疗(transcatheter arterial chemoembolization,TACE)与手术切除(surgical resection,SR)治疗早期原发性肝细胞癌(hepatocellular carcinoma,HCC)的临床疗效。方法通过PubMed、Embase和Medline等外文数据库,及CNKI、维普和万方数据库等中文数据库,检索国内外2013-12-31以前关于比较RFA+TACE与SR治疗早期HCC的病例对照临床试验的文献,根据纳入标准对总体生存率(overall survival rate,OS)、无病生存率(disease-free survival rate,DFS)及术后主要并发症发生率均有详细的分析描述。利用评价指标优势比(OR)及95%可信区间(95%CI)在固定效应模式或随机效应模式下对数据进行合并分析,所有数据均采用Cochrance协作网提供的Revman 4.2软件及Stata 12.0软件进行分析。结果纳入4篇病例对照研究,共697例患者。Meta分析结果显示,手术治疗组5年OS及3和5年DFS明显高于联合治疗组,OR及95%CI分别为0.50(0.32~0.79)、0.66(0.45~0.97)和0.37(0.19~0.72),P值分别为0.003、0.03和0.003;而1、3年OS及1年DFS差异无统计学意义,OR及95%CI分别为1.50(0.77~2.92)、0.94(0.64~1.37)和1.23(0.79~1.90),P值分别为0.23、0.74和0.36。联合治疗组的主要术后并发症发生率低于手术治疗组,OR=0.29,95%CI:0.10~0.78,P=0.01。结论对于早期肝细胞癌,虽然联合治疗术后并发症明显小于手术治疗,但手术治疗的总体疗效仍优与联合治疗。     

腹腔镜与开腹肝门部胆管癌根治术疗效比较的Meta分析

目的:系统评价腹腔镜肝门部胆管癌根治术(laparoscopic radical resection for hilar cholangiocarcinoma, LRRHC)与开腹肝门部胆管癌根治术(open radical resection for hilar cholangiocarcinoma, ORRHC)两种手术方式的临床疗效。方法:以laparoscopy、laparoscopic、laparotomy、open surgery、bile duct neoplasms、hilar cholangiocarcinoma、腹腔镜手术、开腹手术、胆管癌、肝门部胆管癌为检索词,检索PubMed、Embase、the Cochrane Library、CBM、CNKI、VANFUN数据库。检索时间为1960年01月至2020年12月。根据Cochrane系统评价原则,由两名研究者独立筛选文献并提取数据,进行质量评价后使用Review Manager 5.3版进行统计分析。计量资料采用均数差(MD)及其95%可信区间(95%CI)表示,计数资料采用比值比(OR)及其95%CI表示。采...     

Radiofrequency and microwave ablation of lung tumors

Lung cancer is the most common cause of cancer‐related mortality in the United States. Surgical resection remains the standard treatment for early stage, non‐small cell lung cancer, and limited pulmonary metastases. However, many patients with resectable disease have significant co‐morbidities which preclude surgical resection. Radiofrequency and microwave ablation are emerging modalities of treatment for these high‐risk patients. Here, we review the principles, common devices in use, and treatment results of ablative therapy for lung tumors. J. Surg. Oncol. 2009;100:645–650. © 2009 Wiley‐Liss, Inc.     

Ultrasound-guided percutaneous microwave ablation versus surgery for papillary thyroid microcarcinoma

Background: Papillary thyroid microcarcinoma (PTMC) has high incidence and low disease-specific mortality. However, active surveillance is not accepted by most patients owing to high physical or psychological pressures. The emergence of ablation technologies is supplanting traditional surgery. Our goal was to compare the clinical outcomes of microwave ablation (MWA) and surgery for T1aN0M0 PTMC.

Methods: A total of 92 consecutive patients with T1aN0M0 PTMC were studied retrospectively. Forty-six patients had been treated with MWA, and the other 46 had undergone surgery. MWA was performed using extensive ablation extending from the nodule’s lower pole to the upper pole. Surgery was performed by total thyroidectomy or thyroid lobectomy. We compared the two groups in terms of mean length of stay, cost, mean blood loss, surgical incision, operating room (OR) time, quality of life (QOL) assessment, complications, and therapeutic efficacy over a follow-up period of 42 months.

Results: The mean length of stay, cost, mean blood loss, surgical incisions, OR time, and complications in the MWA group were significantly lower than those of the surgery group. The QOL after MWA was higher than it was after surgery. The nodule volume decreased significantly from 53.61?±?48.43?mm³ to 4.84?±?6.55?mm³ (p?Conclusions: MWA may be considered a minimally invasive alternative to surgery for solitary T1aN0M0 PTMC with low incidence of complications and good therapeutic effect.     

肝内胆管癌精索转移1例

  目的  研究分析肝内胆管癌（intrhepatic cholangiocarcinoma, ICC）的临床转移特点、治疗及预后。  方法  回顾性分析1989年1月至2009年12月本院收治的103例肝内胆管癌的临床资料, 分析根治手术与姑息手术、非手术治疗后患者预后的差异。  结果  103例肝内胆管癌患者1、3、5年总体生存率分别为66.1%, 30.1%, 18.4%, 中位生存时间20个月。根治手术组1、3、5年生存率分别为75.3%, 48.2%, 33.9%, 与姑息手术组（46.3%, 0, 0）、非手术组（7.7%, 0, 0）之间的差异有统计学意义。单因素分析表明患者的肿瘤直径、组织学分化程度、肿瘤单发或多发、门静脉、淋巴结、腹膜转移、手术方式为影响肝内胆管癌预后的危险因素。多因素分析显示组织学分化程度、有无门静脉转移、淋巴结转移、腹膜转移及手术方式是影响预后的独立因素。  结论  ICC淋巴结转移率高, 肝内复发是导致死亡的重要因素, 根治性手术切除是ICC最有效的治疗方法。组织学分化程度、门静脉转移、淋巴结转移、腹膜转移及手术方式是影响ICC患者预后的独立危险因素。