Surgical treatment and prognosis analysis of intrahepatic cholangiocarcinoma with different lymph node metastasis status
10.3760/cma.j.issn.1673-4203.2020.02.002
- VernacularTitle: 不同淋巴结转移状态下肝内胆管细胞癌的外科治疗及预后分析
- Author:
Xing ZHANG
1
;
Kai QU
1
;
Zhixin WANG
2
;
Chang LIU
1
Author Information
1. Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi′an Jiaotong University, Xi′an 710061, China
2. Department of Hepatopancreatobiliary Surgery, the Affiliated Hospital of Qinghai University, Xining 810001, China
- Publication Type:Journal Article
- Keywords:
Bile duct neoplasms;
Lymph node excision;
Prognosis;
Intrahepatic cholangiocarcinoma;
Lymph node metastasis;
Radiotherapy and chemotherapy
- From:
International Journal of Surgery
2020;47(2):77-81,f3
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the effects of different N stages, surgical treatment, lymph node dissection and combined chemoradiotherapy on the prognosis of intrahepatic cholangiocarcinoma (ICC).
Methods:The clinical data and follow-up results of 4 555 ICCs in the SEER database were retrospectively analyzed. Including 3 710 patients with N0 phase and 845 patients with N1, all patients included complete TNM staging information, survival time and survival status information, surgical related information and radiotherapy and chemotherapy treatment information. The survival curve was described by Kaplan-Meier method. The survival of 120 months was described. The hypothesis test was performed by Log-rank test. The overall prognosis of patients with different N-stage ICCs was observed. Different surgical methods, lymph nodes were removed, and postoperatively. The effect of chemoradiotherapy on the prognosis of patients with different N-stage ICC. Measurement data with skewed distribution were expressed as medians, and count data were expressed as percentages.
Results:The median survival time of N1 patients was 12 months while 15 months in N0 patients. In N0 patients, the median survival time was 8 months of no operation performed patients, 26 months of local tumor destruction patients, and 45-59 months of surgical treatment performed patients. In N1 patients, the survival time was 9 months, 26 months and 14-22 months of no operation performed, local tumor destruction and surgical treatment performed patients, respectively. In the N0 stage, the median survival time was 37 months for lymph node dissection not performed patients, and the median survival time for lymph node dissection patients was 46-55 months. In N1 patients, the median survival time was 26 months and 18-20 months for without or with lymph node dissection patients. In the N0 stage, the median survival time was 41-42 months for without chemo- or radio-therapy, and it was 43-46 months for with chemo- or radio-therapy patients. In the N1 stage, the median survival time 10-17 months and 23 months for without or with chemo- or radio-therapy patients.
Conclusions:The prognosis of patients with N1 in ICC is significantly worse than that in patients with N0. Surgery is an effective method for the treatment of ICC. At the same time, routine lymphadenectomy should be recommended. Patients with N1 are recommended for radiotherapy and chemotherapy.
