Prognostic Factor of Intrahepatic Cholangiocarcinoma

Kyeong Eui KIM,Keun Soo AHN,Yong Hoon KIM,Tae-Seok KIM,Koo Jeong KANG

Annals of Hepato-Biliary-Pancreatic Surgery（2023）

Division of HBP Surgery

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Abstract

Background:We evaluated prognostic factors of intrahepatic cholangiocarcinoma (iCCA), and analyzed impact of mass size.Methods: Between 2001 and 2020, surgical resection for iCCA was performed in 204 patients.We analyzed demographic factor, perioperative results and long term prognostic factors.Results: Mean age of patients was 66.1 ± 9.7.Mass forming type was most frequent (n = 124), followed by periductal infiltrating (n = 59) and intraductal growing (n = 21).Overall 5 year survival was 33.9%, and disease-free survival rate was 23%.On univariate analysis, mass size larger than 5 cm, high CEA level, portal vein invasion, perineural invasion, lymphovascular invasion and lymph node metastasis were significant poor prognostic factors.Patients with small less than 5 cm sized had good prognosis (53.6% of 5-year overall survival).On multivariate analysis, present of lymph node metastasis was significant independent poor prognostic factor.Conclusions: Present retrospective study showed that patients with small mass less than 5 cm sized without lymph node metastasis may have good prognosis.

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【要点】：本文研究了肝内胆管癌(iCCA)的预后因素，发现肿瘤大小小于5cm且无淋巴结转移的患者预后较好。

【方法】：通过回顾性分析2001年至2020年间接受手术治疗的204例iCCA患者的人口学特征、围手术期结果和长期预后因素。

【实验】：在分析的204例患者中，平均年龄为66.1±9.7岁，最常见的肿瘤类型为肿块型（n=124），其次是导管周围浸润型（n=59）和导管内生长型（n=21）。总体5年生存率为33.9%，无病生存率为23%。单变量分析显示，肿瘤大小超过5cm、CEA水平高、门静脉侵犯、神经侵犯、淋巴管侵犯和淋巴结转移是不良预后的显著因素。肿瘤小于5cm的患者预后较好（5年总体生存率为53.6%）。多变量分析表明，淋巴结转移是显著的独立不良预后因素。

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