CAJ | 학술논문

目的分析76例远端胆管癌的临床和随访资料,研究影响远端胆管癌预后的因素.方法回顾性分析1996年1月至2006年12月76例远端胆管癌患者的临床资料,以Cox回归模型,选择若干对预后可能产生影响的因素进行统计学分析,筛选影响预后的独立因素.结果 76例患者中,男性46例,女性30例,年龄21～88岁,中位年龄65岁.63例行手术治疗,其中21例行姑息性手术,42例行根治性切除术.根治术后1、3、5年的生存率分别为88%,41%,29%,中位生存期为33个月,根治性手术明显好于姑息性性手术(P=0.000).38例患者死于肝转移或术后复发.统计分析显示,患者的预后与年龄、性别、不同的肿瘤大小及分化情况、胰腺浸润、十二指肠浸润等因素无明显相关;而与是否行根治性手术以及是否存在肝转移显著相关.结论根治性手术切除是主要的治疗措施,预防和治疗肝转移对于改善远端胆管癌患者的预后有重要意义.
목적 분석76례원단담관암적림상화수방자료,연구영향원단담관암예후적인소.방법 회고성분석1996년1월지2006년12월76례원단담관암환자적림상자료,이Cox회귀모형,선택약간대예후가능산생영향적인소진행통계학분석,사선영향예후적독립인소.결과 76례환자중,남성46례,녀성30례,년령21～88세,중위년령65세.63례행수술치료,기중21례행고식성수술,42례행근치성절제술.근치술후1、3、5년적생존솔분별위88%,41%,29%,중위생존기위33개월,근치성수술명현호우고식성성수술(P=0.000).38례환자사우간전이혹술후복발.통계분석현시,환자적예후여년령、성별、불동적종류대소급분화정황、이선침윤、십이지장침윤등인소무명현상관;이여시부행근치성수술이급시부존재간전이현저상관.결론 근치성수술절제시주요적치료조시,예방화치료간전이대우개선원단담관암환자적예후유중요의의.
Objective To assess the long-term survival and prognosfie factors in a series of patients with distal bile duet carcinoma. Methods A retrospective clinical analysis was made on 76 cases of distal bile duct cancer who were admitted into our hospital from January 1996 to December 2006. Clinicopathologic factors with possible prognostic significanees were selected and analyzed. Survival was calculated with the Kaplan-Meier method. A multivariate analysis of these individuals was performed using the Cox proportional Hazards Model. Results There were 46 males and 30 females. The age ranged from 21 to 88 years with a mean of 65.21 patients received palliative surgery including, bypass procedure, intraoperative biliary stenting, or percutaneous transhepatie biliary drainage. Radical resection was performed on 42 cases and the 1-, 3- and 5-yeur survival rates were 88.0%, 41.3% and 29.2% respectively. 38 cases died of liver metastasis or recurrence. In multivariate analysis, surgical procedure (P = 0.006) and liver metastasis (P = 0.008), but not sex, age, invasion of pancreas, invasion of duodenum, diameter or differentiation of tumor, were significant independent prognostic factors. Conclusions Radical resection is only curative treatment modality. Prevention on postoperative liver metastasis is essential for improving survival.