肝内胆管结石影响肝内胆管癌患者手术预后的回顾性分析OACSTPCD

Objective To explore the prognostic implications of intrahepatic bile duct stones(IBDS)on patients with intrahepatic cholangiocarcinoma(ICC)who have undergone radical surgery.Methods A total of 204 ICC patients who underwent radical surgery between Jan.2010 and Sep.2022 were categorized into two groups based on the presence of IBDS:the IBDS negative group(n=179)and the IBDS positive group(n=25).The Kaplan-Meier method was utilized to construct survival curves and determine cumulative survival rates.Additionally,the Log-rank test and Cox regression model were used to assess the factors influencing the prognosis of surgical intervention.Results The 1-,3-,and 5-year overall survival rates for the IBDS negative group were 73.8%vs 40.0%,52.0%vs 26.7%,and 34.9%vs 0,with a median overall survival(OS)of 20.2 months vs 10.0 months.Additionally,the 1-,3-,and 5-year recurrence-free survival rates for this group were 54.0%vs 20.0%,30.2%vs 15.0%,and 25.7%vs 0,with a median recurrence-free survival(RFS)of 13.1 months vs 7.6 months.The differences between the two groups were statistically significant(P<0.01).Within the IBDS positive group,a subgroup analysis was conducted,revealing that lymph node metastasis significantly impacted the postoperative OS of ICC patients(P=0.012),as well as reducing the postoperative RFS of ICC patients(P=0.004).Conclusion IBDS was found to have a significant negative impact on the long-term outcomes following radical surgery in patients with ICC,with lymph node metastasis playing a crucial role in determining the prognosis of IBDS-positive ICC patients.Therefore,a focus on the management of IBDS and strategies for preventing metastasis may lead to improved prognostic outcomes for patients with ICC.