医学新知2026，Vol.36Issue(4)：385-392,8.DOI:10.12173/j.issn.1004-5511.202510082
术后经导管动脉灌注与全身辅助治疗对肝门部胆管癌R1切除患者预后的影响
The impact of postoperative transcatheter arterial infusion and systemic adjuvant therapy on prognosis in patients with R1 resection for hilar cholangiocarcinoma
摘要
Abstract
Objective Exploring the impact of postoperative transarterial infusion(TAI)and systemic adjuvant therapy on the prognosis of patients with hilar cholangiocarcinoma(HCCA)who have undergone R1 resection.Methods Retrospectively analyze the clinical data of HCCA patients who underwent R1 surgical resection at The Second Affiliated Hospital of Kunming Medical University from July 2015 to December 2023.According to postoperative adjuvant treatment methods,they were divided into the surgery-only group,the TAI-based adjuvant therapy group,and the systemic adjuvant therapy group.Kaplan-Meier method was used to plot overall survival(OS)and progression-free survival(PFS)curves,the Log-rank test was used to compare intergroup differences,and the Cox proportional hazards model was used to analyze independent prognostic factors affecting OS and PFS.Results A total of 74 HCCA patients with R1 resection were included,32 in the surgery-only group,21 in the TAI-based adjuvant therapy group,and 21 in the systemic adjuvant therapy group.The median OS was 11.0 months[95%CI(7.3,37.9)],34.0 months[95%CI(30.8,63.5)],and 33.0 months[95%CI(30.1,62.8)],respectively.The median OS in the surgery-only group was significantly lower than that in the TAI-based adjuvant therapy group and the systemic adjuvant therapy group(P<0.05).Multivariate Cox regression analysis revealed that,compared with the surgery-only group,TAI-based adjuvant therapy[HR=0.406,95%CI(0.190,0.868),P=0.021]and systemic adjuvant therapy[HR=0.414,95%CI(0.197,0.873),P=0.020]were independent protective factors for OS.The median PFS for the surgery-only group,TAI-based adjuvant therapy group,and systemic adjuvant therapy group was 8.0 months[95%CI(6.9,26.6)],14.0 months[95%CI(9.5,29.9)],and 28.0 months[95%CI(21.2,38.5)],respectively.The median PFS in the surgery-only group was significantly lower than that in the systemic adjuvant therapy group(P<0.05).Multivariate Cox regression analysis indicated that,compared with the surgery-only group,systemic adjuvant therapy[HR=0.446,95%CI(0.226,0.879),P=0.020]was an independent protective factor for PFS.Conclusion Among patients with R1 resection of HCCA,postoperative systemic adjuvant therapy significantly prolonged both OS and PFS compared with no adjutant therapy,while TAI significantly prolonged OS but not PFS.关键词
肝门部胆管癌/R1切除/术后辅助治疗/经导管动脉灌注术/总生存期/无进展生存期Key words
Hilar cholangiocarcinoma/R1 resection/Postoperative adjuvant therapy/Transcatheter arterial infusion/Overall survival/Progression-free survival分类
医药卫生引用本文复制引用
耿钦,钱春行,李国旺,康强,柯阳,李婧,杨晨,李越华..术后经导管动脉灌注与全身辅助治疗对肝门部胆管癌R1切除患者预后的影响[J].医学新知,2026,36(4):385-392,8.基金项目
国家自然科学基金地区科学基金项目(82460461) （82460461）
云南省科技厅科技计划项目(202401AWO70003) （202401AWO70003）
云南省教育厅科学研究基金项目(2025J325) （2025J325）
云南省中青年学术和技术带头人后备人才项目(202205AC160063) （202205AC160063）
