Factors Influencing Results Of Surgical Therapy For Hilar Cholangiocarcinoma

ObjectiveHilar cholangiocarcinoma, comprising 50%-75% of the bile duct tumors, is one of the most common carcinomas in the external liver's bile duct. It is difficult to treat this disease, and the prognosis is poor. We will analyze retrospectively the clinical datum on 73 patients with hilar cholangiocarcinoma. The aim of this study is to evaluate the factors influencing results of surgical therapy for hilar cholangiocarcinoma.MethodsThe clinical and pathological data of 73 cases with hilar cholangiocarcinoma treated surgically in the First Affiliated Hospital of Zhengzhou University from January, 1986 to December, 2003 were collected. Of the 73 cases, 34 cases undergone resection, and 29 cases underwent internal drainage and 10 casesunderwent external drainage. Follow-up was gotten in 62 cases. Follow-up rate was 85.0% (62/73). According to operation pattern, 73 cases were divided into resection group, internal drainage group and external drainage group. Sex, age, operation pattern, lymph node metastasis, liver invasion, vascular invasion, metastasis dissemination, histological type, 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 9 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. The results 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 431?2d, 205?5d and 163?7d respectively, and there was statistical significance (P0.05). Average survival time of well-differentiated adenocarcinoma group, moderately adenocarcinoma group, poorly differentiated adenocarcinoma group and adenosquamous carcinoma group were 463?2d, 248?0d, 141?8d and 205?1d respectively, and there was statistical significance (P<0.05). Average survival time of no lymph node group and lymph node group were 351?2d and 167?1d respectively, and there was statistical significance (PO.05). Average survival time of no vascular invasiongroup and vascular invasion group invssion were 343?1d and 168?2d respectively, and there was statistical significance (P<0.05). Average survival time of no metastasis dissemination group and metastasis dissemination group were 302?9d, 89?2d respectively, and there was statistical significance (P<0.05). Average survival time of male and female were 316?5d and 270?3d respectively, and there was no statistical significance (P>0.05). Average survival time of <40yr old group, 40~60yr group old and >0yr old group were 346?23d, 270?2d and 288?3d respectively, and there was no statistical significance (P>0.05). Average survival time of no liver invasion group and liver invasion group were 284?0d and 290?7d respectively, and there was no statistical significance (P>0.05). Average survival time of preoperative serum albumin of <30g/L group, 30~35g/L group and >5g/L group were 258?8d, 279?9d and 311?8d respectively, and there was no statistical significance (P>0.05). Moreover, there was statistical significance between resection group and internal drainage group, resection group and external drainage group (P<0.05). There was no statistical significance between internal drainage group and external drainage group (P>0.05). 1 yr survival rate of resection group, internal drainage group and external drainage group were 94.12%, 34.48% and 30.00% respectively, and there was statistical significance between resection group and internal drainage group, resection group and external drainage group (P<0.05).There was no statistical significance between internal drainage group and external drainage group(P>0.05). There was statistical significance between well-differentiatedadenocarcinoma group and moderately adenocarcinoma group, well-differentiated ade...