지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2007.8
- 수록면
- 156 - 164 (9page)
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초록· 키워드
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Purpose: The aim of the present study was to find the proper treatment for improving the survival of patients with hilar cholangiocarcinoma by analyzing many factors affecting the patients’ survival.
Methods: Between January 1991 and April 2006, 152 patients with hilar cholangiocarcinoma and who underwent surgery were reviewed. One hundred fifteen patients underwent attempted curative resections, and 37 patients had findings that precluded any further intervention. Of the 115 patients who underwent curative resection, 38 patients underwent resection of the extrahepatic bile duct only and 77 patients underwent concomitant hepatectomy. The clinicopathogical data of these patients was analyzed.
Results: The 3 year overall survival and disease-free survival rates were 41.2% and 52.5%, respectively. The overall recurrence rate was 40.9% (47/115) and of patients with recurrence, those who had been treated aggressively survived longer than those who had been treated conservatively (P=.039). Of the patients’ factors that affected survival, only preoperative weight loss was meaningful (P=.024). Of the histologic factors, tumor cell differentiation (P=.048) and the presence of lymph node metastasis (P=.028) were associated with survival. Of the perioperative factors, only achievement of complete tumor resection affected survival. On comparing between resection of the extrahepatic bile duct only and concomitant partial hepatectomy, the latter achieved more definitely negative histologic margins (63.6% vs 39.5%, respectively, P=.037) at the expense of a more prolonged operation time and hospital stay and greater complications.
Conclusion: Preoperative weight loss, poor differentiation, lymph node metastasis and a positive histologic margin could be included in the poor prognostic factors affecting survival. Concomitant liver resection could be rationalized in that it could attain a more negative histologic margin for treating resectable hilar cholangiocarcinoma, but it could increase mortality and morbidity rates.
Methods: Between January 1991 and April 2006, 152 patients with hilar cholangiocarcinoma and who underwent surgery were reviewed. One hundred fifteen patients underwent attempted curative resections, and 37 patients had findings that precluded any further intervention. Of the 115 patients who underwent curative resection, 38 patients underwent resection of the extrahepatic bile duct only and 77 patients underwent concomitant hepatectomy. The clinicopathogical data of these patients was analyzed.
Results: The 3 year overall survival and disease-free survival rates were 41.2% and 52.5%, respectively. The overall recurrence rate was 40.9% (47/115) and of patients with recurrence, those who had been treated aggressively survived longer than those who had been treated conservatively (P=.039). Of the patients’ factors that affected survival, only preoperative weight loss was meaningful (P=.024). Of the histologic factors, tumor cell differentiation (P=.048) and the presence of lymph node metastasis (P=.028) were associated with survival. Of the perioperative factors, only achievement of complete tumor resection affected survival. On comparing between resection of the extrahepatic bile duct only and concomitant partial hepatectomy, the latter achieved more definitely negative histologic margins (63.6% vs 39.5%, respectively, P=.037) at the expense of a more prolonged operation time and hospital stay and greater complications.
Conclusion: Preoperative weight loss, poor differentiation, lymph node metastasis and a positive histologic margin could be included in the poor prognostic factors affecting survival. Concomitant liver resection could be rationalized in that it could attain a more negative histologic margin for treating resectable hilar cholangiocarcinoma, but it could increase mortality and morbidity rates.
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REFERENCES
참고문헌 (24)
참고문헌 신청
1. [학술지(정기간행물)] - Launois B / 1999 / Proximal bile duct cancer: high resectability rate and 5-year survival / Ann Surg 230 : 266 ~ 275
2. [학술지(정기간행물)] - Burke EC / 1998 / Hilar cholangiocarcinoma; patterns of spread, the importance of hepatic resection for curative operation, and a presurgical clinical staging system / Ann Surg 228 : 385 ~ 392
3. [학술지(정기간행물)] - Su CH / 1996 / Factors influencing postoperative morbidity, mortality and survival after resection for hilar cholangiocarcinoma / Ann Surg 223 : 384 ~ 394
4. [학술지(정기간행물)] - Dinant S / 2006 / Improved outcome of resection of hilar cholangiocarcinoma / Ann Surg Oncol 13 : 872 ~ 880
5. [학술지(정기간행물)] - Beazley RM / 1984 / Clinicopathological aspects of high bile duct cancer: experience with resection and bypass surgical treatments / Ann Surg 199 : 623 ~ 634
2. [학술지(정기간행물)] - Burke EC / 1998 / Hilar cholangiocarcinoma; patterns of spread, the importance of hepatic resection for curative operation, and a presurgical clinical staging system / Ann Surg 228 : 385 ~ 392
3. [학술지(정기간행물)] - Su CH / 1996 / Factors influencing postoperative morbidity, mortality and survival after resection for hilar cholangiocarcinoma / Ann Surg 223 : 384 ~ 394
4. [학술지(정기간행물)] - Dinant S / 2006 / Improved outcome of resection of hilar cholangiocarcinoma / Ann Surg Oncol 13 : 872 ~ 880
5. [학술지(정기간행물)] - Beazley RM / 1984 / Clinicopathological aspects of high bile duct cancer: experience with resection and bypass surgical treatments / Ann Surg 199 : 623 ~ 634
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UCI(KEPA) : I410-ECN-0101-2013-514-002673312