The role of anatomical hepatectomy in the treatment of intrahepatic cholangiocarcinoma
10.3760/cma.j.issn.0529-5815.2018.04.005
- VernacularTitle: 解剖性肝切除在肝内胆管癌治疗中的价值
- Author:
Xiangsong WU
1
;
Yan CHEN
;
Yunpeng JIN
;
Maolan LI
;
Wenguang WU
;
Wei GONG
;
Yingbin LIU
;
Shuyou PENG
Author Information
1. Department of General Surgery, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Research Center of Biliary Tract Disease, Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai 200092, China
- Publication Type:Journal Article
- Keywords:
Liver neoplasms;
Hepatectomy;
Intrahepatic cholangiocarcinoma;
Anatomical hepatectomy
- From:
Chinese Journal of Surgery
2018;56(4):269-273
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the role of anatomical hepatectomy in the treatment of intrahepatic cholangiocarcinoma.
Methods:The cases of intrahepatic cholangiocarcinoma who received curative surgery in two hospitals from 2010 to 2015 were analyzed retrospectively. Among the 98 patients enrolled in this study, 55 were male and 43 were female. The median age was 61 years. According to receiving anatomical hepatectomy or not, the 98 cases were divided into two groups: non-anatomical hepatectomy(n=30) and anatomical hepatectomy(n=68). The surgical results were compared between the two groups.Survival curves were plotted by the Kaplan-Meier method and compared by the log-rank test. The influence of each prognostic factor identified by univariate analysis was multivariate analysis by Cox′s proportional hazard regression.
Results:The duration of surgery was significantly prolonged in the anatomical hepatectomy group((196.4±94.9)minutes vs. (166.2±65.7)minutes, P=0.027), while there was no significant difference in terms of other surgical results such as intraoperative blood transfusion, postoperative morbidity and mortality rate. Compared to non-anatomical hepatectomy, anatomical hepatectomy significantly improved long-term survival results(14 months vs. 11 months)(χ2=4.641, P=0.031). Single variable analysis indicated that tumor differentiation, tumor numbers, T stage, N stage, anatomical hepatectomy and adjuvant therapy significantly affected overall survival. Multivariate analysis demonstrated that tumor numbers(HR=0.522, 95% CI: 0.259-0.974, P=0.042) and anatomical hepatectomy(HR=1.858, 95%CI: 1.092-3.161, P=0.022) were two independent prognostic factors for overall survival.
Conclusion:Compared to non-anatomical hepatectomy, anatomical hepatectomy performed for intrahepatic cholangiocarcinoma is not only safe but also beneficial for long-term survival.
