中国普通外科杂志2024，Vol.33Issue(2)：184-192,9.DOI:10.7659/j.issn.1005-6947.2024.02.004
肿瘤大小对单发肝内胆管癌术后预后影响的多中心回顾性分析
Prognostic impact of tumor size on postoperative prognosis of solitary intrahepatic cholangiocarcinoma:a multicenter retrospective analysis
摘要
Abstract
Background and Aims:Intrahepatic cholangiocarcinoma(ICC)is a highly malignant tumor with poor prognosis.Surgical resection is the preferred treatment in clinical practice,but patients often experience high rates of postoperative recurrence.the incidence of ICC has been steadily increasing over the past 30 years.Tumor size,as an important prognostic factor,significantly affects the survival outcomes of patients.This study was conducted to investigate the impact of tumor size on the prognosis of patients with solitary ICC after radical resection,so as to provide more accurate prognostic assessment for clinical decision-making. Methods:The clinicopathologic data of 654 patients who underwent radical resection and were pathologically diagnosed with ICC between December 2011 and December 2017 in 13 hospitals across China were retrospectively analyzed.Cox regression analysis was used to identify prognostic factors for ICC patients,Kaplan-Meier method was used to plot survival curves,and Log-rank test was used to compare overall survival(OS)differences among patients with different tumor sizes. Results:A total of 307 patients were included.There were 40 cases(13.03％)with tumor size ≤3 cm,177 cases(57.65％)with tumor size＞5 cm,and 90 cases(29.32％)with tumor size＞3-5 cm.Cox regression analysis revealed that margin status,pathological lymph node status,satellite nodules,and tumor size＞5 cm were independent risk factors for the prognosis of solitary ICC patients(all P＜0.05).The 1-,3-,and 5-year OS rates for patients with tumors ≤3 cm were 83.3％,73.8％,and 54.7％,for patients with tumors＞3-5 cm were 81.1％,40.7％,and 36.1％,and for patients with tumors＞5 cm were 72.1％,37.7％,and 29.0％,respectively(P=0.021).Patients with different tumor sizes were grouped and compared based on whether lymph node dissection was performed.The results showed that in ICC patients with tumor size ≤3 cm,there was no significant difference in OS rate between the two groups(P=0.780);in patients with tumor size＞3-5 cm,those not undergoing lymph node dissection had significantly higher OS rate than those undergoing lymph node dissection(P=0.017);in patients with tumor size＞5 cm,those who underwent lymph node dissection had significantly higher OS rate than those who did not(P=0.025). Conclusion:In patients with solitary ICC,those with tumors ≤3 cm have a relatively better prognosis.For patients with solitary ICC and tumors＞5 cm,lymph node dissection surgery is recommended.关键词
胆管肿瘤/胆管,肝内/淋巴结切除术/预后/多中心研究Key words
Bile Duct Neoplasms/Bile Ducts,Intrahepatic/Lymph Node Excision/Prognosis/Multicenter Study分类
医药卫生引用本文复制引用
范瑞林,王剑明,郭伟,李富宇,王坚,郑亚民,李敬东,程石,曾永毅,刘红枝,林起柱,黄霆峰,周伟平,程张军,楼健颖,郑树国,毕新宇..肿瘤大小对单发肝内胆管癌术后预后影响的多中心回顾性分析[J].中国普通外科杂志,2024,33(2):184-192,9.基金项目
国家自然科学基金面上基金资助项目(62275050) （62275050）
福建省科技创新联合基金资金项目(2019Y9108) （2019Y9108）
福建省卫健委中青年科研重大基金资助项目(2021ZQNZD013). （2021ZQNZD013）
