Original Article
Prognosis and related risk factors of distal cholangiocarcinoma after surgical treatment
Lyu Shaocheng, Zhang Zhihua, Li Lixin, Ren Zhangyong, Cao Di, Lang Ren, He Qiang
Published 2020-06-15
Cite as Int J Surg, 2020, 47(6): 369-373,f3. DOI: 10.3760/cma.j.cn115396-20200413-00098
Abstract
ObjectiveTo evaluate the prognosis and related risk factors of distal cholangiocarcinoma after surgical treatment.
MethodsThe clinical data of 123 patients of distal cholangiocarcinoma in Beijing Chaoyang Hospital between January 2011 and December 2019 were retrospectively analyzed, which including 72 males and 51 females, the average age was (64.9±9.2) years (range from 29 to 84 years). All patients underwent pancreatoduodenectomy. The observation measures contains: (1) Perioperative outcomes; (2) Follow-up outcomes; (3) Risk factors for long-term survival of distal cholangiocarcinoma. Follow-up was carried out to understand the long-term survival of patients, and follow-up method contains the outpatient reexamination and telephone. The deadline of follow-up date was March 2020. The normal distribution data were expressed by (Mean±SD), and the non-normal distribution data were expressed by M (P25, P75). Count data were expressed by cases and percentage. Kaplan-Meier method was used to calculate and draw the survival curve. Log-rank test was used to compare the survival rate. Cox proportional risk model was used in multivariate factor analysis.
Results(1) Perioperative outcomes: In our research, all of 123 patients were successfully completed the operations, and 6 patients dead during the perioperative. (2) Follow-up outcomes: The incidence of postoperative complications was 27.6%(34/123). One hundred and twenty-one patients were followed up, the follow-up rate was 98.4%, and the median follow-up time was 41.0 months.The overall 1-year, 2-year, 3-year and 5-year survival rates were 71.8%, 50.5%, 35.5% and 30.2%. And the median survival time was 42.7 months. (3) Risk factors for long-term survival of distal cholangiocarcinoma: Multivariate analysis showed that preoperative CA19-9 (RR=1.470, 95%CI: 1.028-2.101), portal venous system invasion (RR=2.020, 95%CI: 1.012-4.035) and tumor differentiation (RR=1.735, 95%CI: 1.195-2.520) were independent risk factors for the prognosis.
ConclusionsRadical pancreatoduodenectomy is the best treatment for distal cholangiocarcinoma. Preoperative CA19-9 level, portal venous system invasion and tumor differentiation are independent risk factors for the prognosis.
Key words:
Bile duct neoplasms; Pancreatoduodenectomy; Prognosis; Risk factors
Contributor Information
Lyu Shaocheng
Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
Zhang Zhihua
Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
Li Lixin
Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
Ren Zhangyong
Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
Cao Di
Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
Lang Ren
Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
He Qiang
Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
