中国普通外科杂志2025，Vol.34Issue(8)：1671-1679,9.DOI:10.7659/j.issn.1005-6947.250309
代谢综合征对肝门部胆管癌根治性切除术后围手术期及远期结局的影响
Impact of metabolic syndrome on perioperative and long-term outcomes after radical resection for perihilar cholangiocarcinoma
闵柯 1李子沐 1刘智鹏 1戴海粟 1白洁 1江艳 1陈志宇1
作者信息
- 1. 中国人民解放军陆军军医大学第一附属医院肝胆外科/全军肝胆外科研究所,重庆 400038
- 折叠
摘要
Abstract
Background and Aims:Perihilar cholangiocarcinoma(pCCA)is associated with poor prognosis.Radical resection remains the mainstay of treatment;however,high recurrence rates and limited overall survival(OS)after surgery.Metabolic syndrome(MetS)has been linked to unfavorable outcomes in various malignancies,but its impact on postoperative outcomes in pCCA is unclear.This study aimed to evaluate the influence of MetS on perioperative and long-term outcomes in patients undergoing radical resection for pCCA.
Methods:A retrospective analysis was conducted on 223 patients who underwent radical resection for pCCA at the First Affiliated Hospital of Army Medical University between January 2018 and December 2023.Patients were categorized into a MetS group(n=50)and a non-MetS group(n=173)according to diagnostic criteria.Perioperative complications,overall survival(OS),and recurrence-free survival(RFS)were compared between groups.Prognostic factors were identified using multivariate analysis.
Results:No significant differences were observed between the two groups regarding median hospital stay,overall complications,or severe complications(all P＞0.05).The 1-,3-,and 5-year OS rates in the MetS group were 62.3％,22.3％,and 0,respectively,compared with 78.2％,39.5％,and 22.0％in the non-MetS group.Corresponding RFS rates were 46.2％,16.9％,and 0 in the MetS group vs.63.8％,29.6％,and 18.8％in the non-MetS group.Median OS and RFS were significantly shorter in the MetS group than in the non-MetS group(15.0 vs.27.0 months;12.0 vs.21.0 months;P=0.021 and P=0.037,respectively).Multivariate analysis identified MetS and major vascular invasion as independent predictors of OS,while MetS,jaundice,R0 resection,and major vascular invasion were independent predictors of RFS(all P＜0.05).
Conclusion:MetS is significantly associated with worse long-term survival and higher recurrence risk after radical resection for pCCA.Incorporating MetS into preoperative assessment and postoperative management strategies may help improve patient outcomes.关键词
Klatskin肿瘤/代谢综合征/手术后并发症/预后Key words
Klatskin Tumor/Metabolic Syndrome/Perihilar Cholangiocarcinoma/Prognosis分类
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闵柯,李子沐,刘智鹏,戴海粟,白洁,江艳,陈志宇..代谢综合征对肝门部胆管癌根治性切除术后围手术期及远期结局的影响[J].中国普通外科杂志,2025,34(8):1671-1679,9.
