Analysis of Factors Influencing Prognosis of Patients with Bile Duct Carcinoma after Resection_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SUN Xuejun , SHI Jingsen , HE Ping.

Department of Surgery, The First Affiliated Hospital, Medical College of Xi’an Jiaotong University, Xi’an 710061, China;

Corresponding author：

Keywords：

Bile duct carcinoma Operation Cox model Prognostic factor

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【Abstract】ObjectiveTo analyze the factors influencing the prognosis of patients with bile duct carcinoma after resection.
MethodsThe clinical data of 120 patients with bile duct carcinoma receiving resection in our hospital from 1980 to 2004 were collected retrospectively and clinicopathologic factors that might influence survival were analysed. A multiple factor analysis was performed through Cox proportional hazard model.
ResultsThe overall 1year, 3year and 5year survival rates were 71.7%, 32.5% and 19.2% respectively. The single factor analysis showed that the major significant factors influencing survival of these patients were histological type of the lesions, lymph node metastasis, pancreatic infiltration, duodenal infiltration, resected surgical margin, perineural infiltration, peripheral vascular infiltration and depth of tumor infiltration (P＜0.05). Lymph node metastasis, pancreatic infiltration and perineural infiltration were found to be the the statistically significant factors influencing survival by multiple factor analysis through the Cox model.
ConclusionThe most important prognostic factors for bile duct carcinoma after resection were lymph node metastasis, pancreatic infiltration and perineural infiltration.

Citation： SUN Xuejun,SHI Jingsen,HE Ping.. Analysis of Factors Influencing Prognosis of Patients with Bile Duct Carcinoma after Resection. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2006, 13(1): 85-88. doi: Copy

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6.	Yoshida T, Matsumoto T, Sasaki A, et al. Lymphatic spread differs according to tumor location in extrahepatic bile duct cancer [Ｊ]. Hepatogastroenterology, 2003; 50(49)∶17.
7.	Yoshida T, Matsumoto T, Sasaki A, et al. Prognostic factors after pancreatoduodenectomy with extended lymphadenectomy for distal bile duct cancer [Ｊ]. Arch Surg, 2002; 137(1)∶69.
8.	Todoroki T, Kawamoto T, Koike N, et al. Treatment strategy for patients with middle and lower third bile duct cancer [Ｊ]. Br J Surg, 2001; 88(3)∶364.
9.	Havlik R, Sbisa E, Tullo A, et al. Results of resection for hilar cholangiocarcinoma with analysis of prognostic factors [Ｊ]. Hepatogastroenterology, 2000; 47(34)∶927.
10.	Sakamoto Y, Kosuge T, Shimada K, et al. Prognostic factors of surgical resection in middle and distal bile duct cancer: an analysis of 55 patients concerning the significance of ductal and radial margins [Ｊ]. Surgery, 2005; 137(4)∶396.
11.	Wakai T, Shirai Y, Moroda T, et al. Impact of ductal resection margin status on longterm survival in patients undergoing resection for extrahepatic cholangiocarcinoma [Ｊ]. Cancer, 2005; 103(6)∶1210.
12.	Inoue K, Makuuchi M, Takayama T, et al. Longterm survival and prognostic factors in the surgical treatment of massforming type cholangiocarcinoma [Ｊ]. Surgery, 2000; 127(5)∶498.
13.	何平，石景森，陈武科，等. 应用Cox模型分析影响胆管癌切除术后的预后因素 [Ｊ]. 中华肝胆外科杂志， 2002； 8（4）∶219.
14.	Bhuiya MR, Nimura Y, Kamiya J, et al. Clinicopathologic studies on perineural invasion of bile duct carcinoma [Ｊ]. Ann Surg, 1992; 215(4)∶344.

1. Shinchi H, Takao S, Nishida H, et al. Length and quality of survival following external beam radiotherapy combined with expandable metallic stent for unresectable hilar cholangiocarcinoma [Ｊ]. J Surg Oncol, 2000; 75(2)∶89.
2. Reed DN Jr, Vitale GC, Martin R, et al. Bile duct carcinoma: trends in treatment in the nineties [Ｊ]. Am Surg, 2000; 66(8)∶711.
3. Lygidakis NJ, Sgourakis GJ, Dedemadi GV, et al. Longterm results following resectional surgery for Klatskin tumors. A twentyyear personal experience [Ｊ]. Hepatogastroenterology, 2001; 48(37)∶95.
4. Born P, Rosch T, Bruhl K, et al. Longterm outcome in patients with advanced hilar bile duct tumors undergoing palliative endoscopic or percutaneous drainage [Ｊ]. Z Gastroenterol, 2000; 38(6)∶483.
5. 周宁新，黄志强，冯玉泉，等. 肝门部胆管癌103例外科治疗远期疗效的评析 [Ｊ]. 中华外科杂志， 1997； 35（11）∶64.
6. Yoshida T, Matsumoto T, Sasaki A, et al. Lymphatic spread differs according to tumor location in extrahepatic bile duct cancer [Ｊ]. Hepatogastroenterology, 2003; 50(49)∶17.
7. Yoshida T, Matsumoto T, Sasaki A, et al. Prognostic factors after pancreatoduodenectomy with extended lymphadenectomy for distal bile duct cancer [Ｊ]. Arch Surg, 2002; 137(1)∶69.
8. Todoroki T, Kawamoto T, Koike N, et al. Treatment strategy for patients with middle and lower third bile duct cancer [Ｊ]. Br J Surg, 2001; 88(3)∶364.
9. Havlik R, Sbisa E, Tullo A, et al. Results of resection for hilar cholangiocarcinoma with analysis of prognostic factors [Ｊ]. Hepatogastroenterology, 2000; 47(34)∶927.
10. Sakamoto Y, Kosuge T, Shimada K, et al. Prognostic factors of surgical resection in middle and distal bile duct cancer: an analysis of 55 patients concerning the significance of ductal and radial margins [Ｊ]. Surgery, 2005; 137(4)∶396.
11. Wakai T, Shirai Y, Moroda T, et al. Impact of ductal resection margin status on longterm survival in patients undergoing resection for extrahepatic cholangiocarcinoma [Ｊ]. Cancer, 2005; 103(6)∶1210.
12. Inoue K, Makuuchi M, Takayama T, et al. Longterm survival and prognostic factors in the surgical treatment of massforming type cholangiocarcinoma [Ｊ]. Surgery, 2000; 127(5)∶498.
13. 何平，石景森，陈武科，等. 应用Cox模型分析影响胆管癌切除术后的预后因素 [Ｊ]. 中华肝胆外科杂志， 2002； 8（4）∶219.
14. Bhuiya MR, Nimura Y, Kamiya J, et al. Clinicopathologic studies on perineural invasion of bile duct carcinoma [Ｊ]. Ann Surg, 1992; 215(4)∶344.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of Factors Influencing Prognosis of Patients with Bile Duct Carcinoma after Resection

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