- 作者：Yoshitsugu Nakanishi ; MD ; PhD ; y.nakanishi@mac.com" class="auth_mail" title="E-mail the corresponding author ; Takahiro Tsuchikawa ; MD ; PhD ; Keisuke Okamura ; MD ; PhD ; Toru Nakamura ; MD ; PhD ; Eiji Tamoto ; MD ; PhD ; Soichi Murakami ; MD ; PhD ; Yuma Ebihara ; MD ; PhD ; Yo Kurashima ; MD ; PhD ; Takehiro Noji ; MD ; PhD ; Toshimichi Asano ; MD ; PhD ; Toshiaki Shichinohe ; MD ; PhD ; Satoshi Hirano ; MD ; PhD
- 刊名：Surgery
- 出版年：2016
- 出版时间：June 2016
- 年：2016
- 卷：159
- 期：6
- 页码：1511-1519
- 全文大小：320 K
Methods
This study classified 168 patients undergoing resection for perihilar cholangiocarcinoma histologically as without portal vein resection or tumor invasion to the portal vein (PV0), with tumor invasion to unilateral branches of the portal vein (PVt3), or with tumor invasion to the main portal vein or its bilateral branches, or to unilateral second-order biliary radicals with contralateral portal vein involvement (PVt4). Patients in PVt4 were subclassified into the A-M group (cancer invasion limited to the tunica adventitia or media) or the I group (cancer invasion reaching the tunica intima).
Results
Of the patients, 121 were in PV0, 21 were in PVt3, and 26 were in PVt4. There was no difference in survival between the PV0 and PVt3 groups (P = .267). The PVt4 group had a worse prognosis than the PVt3 group (P = .046). In addition, the A-M (n = 19) and I subgroups (n = 7) of PVt4 had worse prognoses than the PV0 or PVt3 groups (P = .005 and < .001, respectively). All patients in the I subgroup of PVt4 died within 9 months after resection. On multivariate analysis, PVt4 (P = .029) was identified as an independent prognostic factor.
Conclusions
In perihilar cholangiocarcinoma, postoperative survival was no different between patients with and without ipsilateral portal vein invasion, although patients with tumor invasion to the main or contralateral branches of the portal vein, especially with tunica intima invasion, had extremely poor prognoses.