肝门部胆管癌预后影响因素分析

目的 探讨影响肝门部胆管癌术后预后的因素.方法 回顾性分析2004年1月-2008年7月收治86例肝门部胆管癌的临床资料,分析影响肝门部胆管癌预后的因素.结果 全组患者的平均生存时间为(13.7±2.3)个月.1年生存率为57.3%,3年生存率为29.7%.切除组(包括根治性切除和姑息性切除)的平均生存时间(19.4±2.2)个月,高于非手术切除组患者的平均生存期(7.2±1.2)个月(P＜0.05).无血管切除组患者的平均生存期为(23.4 ±2.1)个月,明显高于单纯门静脉切除组(15.3±1.4)个月及肝动脉切除组(9.3±0.9)个月(P＜0.05).Cox回归模型分析显示分期、肿瘤直径和手术方式是影响肝门部胆管癌患者预后的因素.而病理类型、血管切除和年龄并不是影响肝门部胆管癌患者预后的因素.结论 肝门部胆管癌的预后与手术治疗方式、肿瘤分期和肿瘤直径因素密切相关.在治疗过程中应慎重选择手术治疗方式.

An analysis on prognostic factors of hilar cholangiocarcinoma

Objective To investigate the influencing factors on the prognosis of hilar cholangiocarcinoma.Methods The clinical data were retrospectively analyzed in 86 cases of hilar eholangiocarcinoma admitted into our hospital from Jan.2004 to July.2008.Results Of 86 cases with hilar eholangiocarcinoma,the mean survival time was 13.7 ± 2.3 months,1-year survival 57.3% and 3-year survival 29.7%.The mean survival time in patients with resection operation ( 19.4 ± 2.2 months ) was significantly longer than those with no operation ( 7.2 ± 1.2 months) (P ＜ 0.05 ).The mean survival time in patients with non-vascular resection group ( 23.4 ± 2.1 months ) was significantly longer than those with portal vein resection alone group (15.3 ± 1.4 months) and hepatic artery resection group (9.3 ± 0.9month) (P ＜ 0.05 ).Cox regression analysis showed that staging,tumor diameter and operative were the dependent prognosis factors while pathologic type,vascular resection and age not the dependent prognosis factors.Conclusion The prognosis of hilar cholangiocarcinoma correlates with operative approach,clinical stage and tumor diameter.A surgeon must be cautious to choose the surgical approach for treatment.