Objective To investigate the surgical effect of hilar cholangiocarcinoma and its impact on prognosis. Method The clinical data of 204 hilar cholangiocarcinoma admitted into the First Hospital of China Medical University were retrospectively analyzed. According to the Bismuth-corlette type, type Ⅰ was 18 cases, type Ⅱ 40 cases, type Ⅲ-a 30 cases, type Ⅲ-b 53 cases, type Ⅳ 57 cases. The other 6 cases was not typed. Color Doppler ultrasound, CT, MRCP were used to determine the Bismuth-Corlette type before the surgery. Based on preoperative image diagnosis the correct diagnosis rate was 53. 7%, 76. 4%, 100% for ultrasound, CT and MRCP respectively. Ninety-two cases underwent tumor resection, including radical resection (R0) in 55 cases, and palliative resection (R1, R2) in 37 cases. Ninety-eight cases underwent exploration and biliary drainage, 6 cases did laparotomy only, 2 cases received liver transplantation. The survival rate (P < 0. 001) is statistically different between patients receiving tumor resection and those not. Radical resection and palliative resection group are also statistically different in survival rates (P < 0. 05). Cox multivariate analysis shows that operation pattern, histological differentiation are two independent prognostic factors. Conclusion Surgery is the main method to treat hilar cholangiocarcinoma and radical resection could achieve the best effect. Reasonable perioperative treatment could reduce the complications and mortality.

Objective To study parameters influencing the prognosis of patients with gallbladder carcinoma.Methods A retrospective clinical analysis was conducted in 96 cases of gallbladder carcinoma treated in this hospital between 1993 and 2003.Results The overall 5-year survival rate of the patients was 6.32%.The 1-, 3-, and 5-year survival rates following radical resection for gallbladder carcinoma were 78.36%, 48.54%, and 23.87%, respectively.The survival rate was remarkably higher in the radical resection group than in others.Multivariate analysis revealed that depth of infiltration of the tumor and surgical procedure were markedly associated with prognosis.Conclusion Early diagnosis and radical resection are still the mainstay for long-term survival of the patients with gallbladder carcinoma.Appropriate perioperative care can improve survival rate.

Objective To investigate the prognostic factors of hilar cholangiocarcinoma. Methods The clinical data of 204 patients with hilar cholangiocarcinoma who were admitted to The First Affiliated Hospital of China Medical University from January 1996 to May 2007 were retrospectively analyzed. The survival rate was calculated using the Kaplan-Meier method and Log-rank test. Seventeen factors that may have influenced prognosis were analyzed by univariate analysis. Factors that were statistically significant were further analyzed by the Cox regression model. Results The median survival times of patients who received radical resection, palliative resec-tion, bile duct exploration and catheter drainage, exploratory laparotomy, and liver transplantation were 37, 18, 11,5 and 25 months, respectively, and there was a significant difference between the 5 groups (χ2 = 58. 300, P < 0. 05). The prognostic factors included tumor size, portal vein or hepatic artery invasion, local invasion, resection margin, tumor grading, lymph node metastasis and surgical procedure (χ2 =6. 541, 8. 159, 5. 837, 4. 365, 13.748, 5.346, 9.472, P <0.05). Multivariate analysis demonstrated that surgical procedure and tumor grading were independent prognostic factors (6=0.287, 0. 320, P <0.05). Conclusions Radical resection is the most important prognostic factor of hilar cholangiocarcinoma. Appropriate perioperative care can improve the survival rate.

Objective:To understand the age composition of breast cancer patients. Methods:The medical records of 115 patients were classified. Results:<60,<50 and<70 age group accounted for 35%, 23%and 20%, and in the same age group, the patients with the birth of one child were in the highest proportion (68%) . In 65 postmenopausal patients,<60 and <50 in postmenopausal age group was 57%and 25%. The clinical stage II ratio was 61.7%, and the distribution in the<60,<50 and<70 age group was in higher proportion. The proportion of nonspecific invasive breast carcinoma (85%) was the highest in all types,<60,<70 and<50 age group accounted for IV the proportion with 35.7%, 22.4%and 20.4%. Conclusions:The percentage of the middle-aged and the aged group (40-69 years old) with breast cancer is significantly higher than the ones of young group (<40 years old) and the senile group (&ge;70 years old) . Clinical stage II and nonspecific invasive breast carcinoma are also concentrated in this stage. Women should improve health consciousness,take regular check to discover timely.