The concept of perihilar cholangiocarcinoma is valid
The concept of perihilar cholangiocarcinoma is valid
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DOI：
10.1002/bjs.6655
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发表时间：
2009-08-01
影响因子：
9.6
通讯作者：
Nagino, M.
中科院分区：
文献类型：
--
作者：
Ebata, T.;Kamiya, J.;Nagino, M.
背景：术语肝门周围胆管癌已被用于所有涉及或需要切除肝汇合部的传言。然而，它不能区分肝内和肝外肝门肿瘤，也没有临床病理基础。这项回顾性研究探讨肝门周围胆管癌的概念是否是有效的clinically.Methods：大约250例肝门周围胆管癌分为肝外（EHC，167例）和肝内（IHC，83）组的肿瘤位置的基础上。结果：肝、门静脉、静脉和淋巴管侵犯以及淋巴结转移在IHC中较EHC常见，而组织学分级和神经周围侵犯的发生率相似。在手术时，IHC更先进;在37.7%的EHC和59%的IHC中发现了III或IV期疾病。EHC患者的生存率略高于IHC患者（5年时29.3%对20%; P = 0.057），但美国癌症联合委员会分类中每个肿瘤阶段的生存率相似。在术语肝门周围胆管癌下结合EHC和IHC是有效的，因为这些肿瘤具有可比的生物学行为，根据分期和侵袭情况进行类似的临床处理。
Background: The term perihilar cholangiocarcinoma has been used for all rumours involving or requiring resection of the hepatic confluence. However, it does not distinguish between intrahepatic and extrahepatic hilar tumours, and has no clinicopathological basis. This retrospective study examined whether the concept of perihilar cholangiocarcinoma is valid clinically.Methods: Some 250 patients with perihilar cholangiocarcinoma were divided into extrahepatic (EHC, 167 patients) and intrahepatic (IHC, 83) groups based on tumour location. Clinicopathological data were compared between these groups.Results: Liver, portal vein, venous and lymphatic invasion, and nodal metastasis were more common in IHCs than EHCs, whereas histological grade and incidence of perineural invasion were similar. IHCs were more advanced at the time of surgery; stage III or IV disease was found in 37.7 per cent of EHCs and 59 per cent of IHCs. Survival was marginally better for patients with EHCs than for those with IHCs (29.3 versus 20 per cent at 5 years; P = 0.057), but survival rates were similar for each tumour stage in the American joint Committee on Cancer classification.Conclusion: Combining EHC and IHC under the term perihilar cholangiocarcinoma is valid, as these tumours have comparable biological behaviour, with similar clinical management depending on stage and invasion.