Analysis of prognostic impact factors of patients with mass-forming intrahepatic cholangiocarcinoma after surgical resection

doi:10.3877/cma.j.issn.2095-3232.2019.01.007

Abstract

Abstract:

Objective

To investigate the risk factors of clinical prognosis of mass-forming intrahepatic cholangiocarcinoma (ICC) patients after surgical resection.

Methods

Clinical data of 48 patients with mass-forming ICC who underwent surgical resection in PLA General Hospital from January 2010 to October 2016 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 33 patients were male and 15 were female, aged from 29 to 73 years with a median age of 53 years. Tumors were located in the right lobe of the liver in 37 cases and left lobe in 11 cases. The mean tumor diameter was (6.8±2.6) cm. All patients underwent R0 resection. The clinicopathological parameters were included in the analysis of prognostic factors. Kaplan-Meier survival curve and Log-rank test were conducted for univariate analysis. Cox's proportional hazard model was conducted for multivariate analysis.

Results

During the postoperative follow-up, 28 cases died and 20 cases survived. The survival time was 3-82 months with a median survival time of 20 months. The 1-, 3- and 5-year survival rate was 95.7%, 50.9% and 14.8%, respectively. Univariate analysis indicated that HBsAg, degree of tumor differentiation, lymph node metastasis and vascular invasion were the impact factors for the survival prognosis (χ²=4.097, 6.415, 11.069, 9.117; P<0.05). Multivariate analysis revealed that lymph node metastasis was an independent risk factor for the prognosis of patients undergoing surgical resection (HR=3.306, 95%CI: 1.184-9.233; P<0.05).

Conclusion

Lymph node metastasis is an independent risk factor for the clinical prognosis of mass-forming ICC patients after surgical resection.

Key words: Intrahepatic cholangiocarcinoma, Hepatectomy, Prognosis, Risk factors

Xiangqian Zhao, Bin Liang, Hangyu Zhang, Jian Feng. Analysis of prognostic impact factors of patients with mass-forming intrahepatic cholangiocarcinoma after surgical resection[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2019, 08(01): 26-30.

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Figures/Tables 3

References 20

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影响因素		例数	1年	3年	5年	χ²值	P值
性别		?	?	?	?	0.455	0.500
?	男	33	93.8	49.8	18.7	?	?
?	女	15	90.0	54.0	13.5	?	?
年龄（岁）		?	?	?	?	0.087	0.768
?	≤53	27	92.3	48.6	21.2	?	?
?	> 53	21	100.0	66.7	10.0	?	?
HBsAg		?	?	?	?	4.097	0.043
?	阴性	35	97.1	59.0	23.3	?	?
?	阳性	13	92.3	30.8	0	?	?
CA19-9		?	?	?	?	0.137	0.711
?	阴性	26	96.0	53.9	12.9	?	?
?	阳性	22	95.5	46.0	20.5	?	?
手术切除范围		?	?	?	?	0.083	0.773
?	局部	25	96.0	50.6	11.4	?	?
?	段/叶	23	95.5	51.7	19.4	?	?
肿瘤直径（cm）		?	?	?	?	3.259	0.071
?	≤7	28	92.9	69.6	16.9	?	?
?	> 7	20	100.0	35.7	8.9	?	?
肿瘤分化程度		?	?	?	?	6.415	0.040
?	低分化	20	89.7	34.5	0	?	?
?	中-低分化	18	100.0	78.0	25.3	?	?
?	中分化	10	100.0	35.7	35.7	?	?
淋巴结转移		?	?	?	?	9.117	0.003
?	阴性	35	85.3	72.5	21.7	?	?
?	阳性	13	92.3	12.8	0	?	?
肿瘤位置		?	?	?	?	0.244	0.621
?	肝左叶	11	100.0	66.7	33.3	?	?
?	肝右叶	37	94.4	47.8	13.4	?	?
切缘宽度（cm）		?	?	?	?	0.834	0.361
?	≤1	21	95.2	40.3	16.1	?	?
?	> 1	27	96	57.3	14.6	?	?
脉管受侵		?	?	?	?	11.069	0.001
?	无	37	97.1	66.3	10.1	?	?
?	有	11	90.9	36.4	0	?	?

影响因素		例数	1年	3年	5年	χ²值	P值
性别		?	?	?	?	0.455	0.500
?	男	33	93.8	49.8	18.7	?	?
?	女	15	90.0	54.0	13.5	?	?
年龄（岁）		?	?	?	?	0.087	0.768
?	≤53	27	92.3	48.6	21.2	?	?
?	> 53	21	100.0	66.7	10.0	?	?
HBsAg		?	?	?	?	4.097	0.043
?	阴性	35	97.1	59.0	23.3	?	?
?	阳性	13	92.3	30.8	0	?	?
CA19-9		?	?	?	?	0.137	0.711
?	阴性	26	96.0	53.9	12.9	?	?
?	阳性	22	95.5	46.0	20.5	?	?
手术切除范围		?	?	?	?	0.083	0.773
?	局部	25	96.0	50.6	11.4	?	?
?	段/叶	23	95.5	51.7	19.4	?	?
肿瘤直径（cm）		?	?	?	?	3.259	0.071
?	≤7	28	92.9	69.6	16.9	?	?
?	> 7	20	100.0	35.7	8.9	?	?
肿瘤分化程度		?	?	?	?	6.415	0.040
?	低分化	20	89.7	34.5	0	?	?
?	中-低分化	18	100.0	78.0	25.3	?	?
?	中分化	10	100.0	35.7	35.7	?	?
淋巴结转移		?	?	?	?	9.117	0.003
?	阴性	35	85.3	72.5	21.7	?	?
?	阳性	13	92.3	12.8	0	?	?
肿瘤位置		?	?	?	?	0.244	0.621
?	肝左叶	11	100.0	66.7	33.3	?	?
?	肝右叶	37	94.4	47.8	13.4	?	?
切缘宽度（cm）		?	?	?	?	0.834	0.361
?	≤1	21	95.2	40.3	16.1	?	?
?	> 1	27	96	57.3	14.6	?	?
脉管受侵		?	?	?	?	11.069	0.001
?	无	37	97.1	66.3	10.1	?	?
?	有	11	90.9	36.4	0	?	?

影响因素	b	SE（b）	wald χ²	HR	95%CI	P值
HBsAg阳性	0.133	0.504	0.070	1.143	0.425～3.070	0.791
低分化	-0.021	0.358	0.004	0.979	0.485～1.976	0.953
淋巴结转移	1.196	0.524	5.209	3.306	1.184～9.233	0.022
脉管受侵	1.018	0.541	3.542	2.769	0.959～7.995	0.060

影响因素	b	SE（b）	wald χ²	HR	95%CI	P值
HBsAg阳性	0.133	0.504	0.070	1.143	0.425～3.070	0.791
低分化	-0.021	0.358	0.004	0.979	0.485～1.976	0.953
淋巴结转移	1.196	0.524	5.209	3.306	1.184～9.233	0.022
脉管受侵	1.018	0.541	3.542	2.769	0.959～7.995	0.060

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