Prognostic Factors Influencing Postoperative Survival After Operation For Hilar Cholangiocarcinoma

Hilar cholangiocarcinoma is one of most common carcinoma in the external liver's bile duct. The morbidity of hilar cholangiocarcinoma is 58%~75% among the bile duct tumors. Up to now, article about factors influencing postoperative survival after operation in hilar cholangiocarcinoma is differ. Objective of the study is to define the prognostic factors in hilar cholangiocarcinoma. Materials and methods The clinical and pathological data of 61 cases with hilarcholangiocarcinoma , from 33 years old to 75 years old, average 56.5 years old, 32 cases male and 29 cases female, treated surgically in the first affiliated hospital, zhengzhou university from January, 1986 to May, 2001 were collected. Of the 61 cases, 24 cases underwent resection, and 23 cases underwent internal drainage and 14 cases underwent external drainage. Follow up was got in 49 cases. Follow up rate was 80.3% (49/61). According to operation pattern, 61 cases were divided into resection group, internal drainage group and external drainage group. Sex, age, operation pattern, lymph node metastasis, liver invasion, portal vein invasion, metastasis dissemination, Bismuth-Corlette type, histological type, preoperative total bilirubin, preoperative serum albumin were the variables that reviewed retrospectively.This study use Kaplan-Meier product-limit method to evaluate survival rate, and Log-rank method to analyze 11 variables. The variables showing statistical significance in the Log-rank method were included in the following multivariate analysis using Cox stepwise proportional hazard model for influencing survival. Theresults are analysed by SPSS 10.0 staistical software, a equals 0.05 were considered significant test level.ResultsAverage survival time of resection group, internal drainage group and external drainage group were 428±45 days, 203±29 days, 169±52 days respectively, and there were statistical significance(P<0.05). Average survival time of well-differentiated adenocarcinoma group, moderately adenocarcinoma group, poorly differentiated adenocarcinoma group, and adenosquamous carcinoma group were 459±37days, 256±46days, 144±40days, 200±88 days respectively, and there were statistical significance(P<0.05). Average survival time of no lymph node group and lymph node group were 345±36 days, 196±40 days respectively, and there was statistical significance(P<0.05). Average survival time of no portal vein invasion group and portal vein invasion group were 338±33 days, 173±44 days respectively, and there was statistical significance(P<0.05). Average survival time of no metastasis dissemination group and metastasisdissemination group were 305±30 days, 87±20 days respectively, and there was statistical significance(P<0.05). Average survival time of male and female were 306±37 days, 260±43 days respectively, and there was no statistical significance(P<0.05). Average survival time of <40 years old group,40-60 years group old and >60 years old group were 435±132 days, 266±37 days,291±46 days respectively, and there were no statistical significance(P>0.05). Average survival time of no liver invasion group and liver invasion group were 282±32 days, 289±59 days respectively, and there was no statistical significance(P>0.05). Average survival time of Bismuth-Corlette I type , II typeJII type and IV type were 404±57 days, 291 ±46 days,245±69 days,213±16 days respectively, and there were no statistical significance(P>0.05). Average survival time of preoperative total bilirubin of 34-170 u- mol/L group,170-340umol/L group and >340 u mol/L group were 311±50 days, 253±45 days, 288±51 days respectively, and there were no statistical significance(P>0.05). Average survival time of preoperative serum albumin of <30g/L group, 30-35g/L group and>35g/L group were 255±60 days, 273±54 days, 306±40 days respectively, and there were no statistical significance (P>0.05). Moreover, there were statistical significance between resection group and...