Trends in survival after surgery for cholangiocarcinoma: A 30-year population-based SEER database analysis
Trends in survival after surgery for cholangiocarcinoma: A 30-year population-based SEER database analysis
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DOI：
10.1007/s11605-007-0282-0
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发表时间：
2007-11-01
影响因子：
3.2
通讯作者：
Schulick, Richard D.
中科院分区：
文献类型：
--
作者：
Nathan, Hari;Pawlik, Timothy M.;Schulick, Richard D.
历史上胆管癌患者的预后一直很差，即使在手术切除后。尽管一些单机构系列研究的数据表明与历史结果相比有所改善，但尚未在基于人群的研究中研究胆管癌手术治疗后的生存率。我们使用监测、流行病学和最终结果数据库来确定1973年至2002年期间接受胆管癌手术的患者。肝内胆管癌术后生存率的多变量模型显示，仅在过去十年中生存率有所改善，从1992年到2002年，生存率累计改善34.4%。相比之下，肝外胆管癌术后生存率的多变量模型显示，每研究10年，校正生存率增加23.3%，从1973年到2002年，累积改善53.7%。我们的结论是，自1973年以来，肝外胆管癌手术后的生存率显著提高。然而，肝内胆管细胞癌患者的生存率的提高主要局限于最近几年。我们认为，这些趋势主要是由于成像技术的发展，患者选择的改善和手术技术的进步。
The prognosis of patients with cholangiocarcinoma historically has been poor, even after surgical resection. Although data from some single-institution series indicate improvement over historical results, survival after surgical therapy for cholangiocarcinoma has not been investigated in a population-based study. We used the Surveillance, Epidemiology, and End Results database to identify patients who underwent surgery for cholangiocarcinoma from 1973 through 2002. Multivariate modeling of survival after surgery for intrahepatic cholangiocarcinoma showed an improvement in survival only within the last decade studied, resulting in a cumulative 34.4% improvement in survival from 1992 through 2002. In contrast, multivariate modeling of survival after surgery for extrahepatic cholangiocarcinoma revealed a 23.3% increase in adjusted survival per each decade studied, resulting in a cumulative 53.7% improvement from 1973 through 2002. We conclude that survival after surgery for extrahepatic cholangiocarcinoma has dramatically improved since 1973. Patients with intrahepatic cholangiocarcinoma, however, have achieved an improvement in survival largely confined to more recent years. We suggest that these trends are largely caused by developments in imaging technology, improvements in patient selection, and advances in surgical techniques.