Concomitant hepatic artery resection for advanced perihilar cholangiocarcinoma: a case-control study with propensity score matching
Concomitant hepatic artery resection for advanced perihilar cholangiocarcinoma: a case-control study with propensity score matching
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DOI：
10.1002/jhbp.363
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发表时间：
2016-07-01
影响因子：
3
通讯作者：
Hirano, Satoshi
中科院分区：
文献类型：
--
作者：
Noji, Takehiro;Tsuchikawa, Takahiro;Hirano, Satoshi
背景肝动脉切除术（HAR）是否能改善晚期肝门部胆管癌的预后仍有争议。本研究的目的是比较短期和长期的手术结果HAR与标准切除术（SR）的肝门周围胆管癌使用倾向评分matching.MethodsAmong 209例肝门周围胆管癌患者接受切除术在我们部门，28例患者进行了HAR，其余181例患者进行了SR。包括手术困难，以1：1的比例使用倾向评分匹配，导致每组24名患者的比较。研究方案已通过我们的机构审查委员会（015-0365），入组UMIN-CTR根据赫尔辛基宣言（Declaration of Helsinki）进行统计分析（Clavien-Dindo IIIa级：SR组为37.5%，HAR组为62.5%; P=0.080），术后肝脓肿形成除外（P=0.020）。5年总生存率分别为30.3%和20.4%。SR和HAR组之间的总生存率无显着差异（P=0.150）。ConclusionDespite是一个苛刻的程序，伴随HAR似乎是可行的肝门周围胆管癌患者选择。
BackgroundWhether concomitant hepatic artery resection (HAR) improves the prognosis for advanced perihilar cholangiocarcinoma remains controversial. The aim of the present study was to compare short- and long-term surgical results of HAR versus standard resection (SR) for perihilar cholangiocarcinoma using propensity score matching.MethodsAmong 209 patients with perihilar cholangiocarcinoma patients who underwent resection in our department, 28 patients underwent HAR, and the remaining 181 patients underwent SR. To adjust for differences in clinicopathological factors, including difficulty in surgery, between groups, propensity score matching was used at a 1:1 ratio, resulting in a comparison of 24 patients per group. The study protocols were approved by our institutional review board (015-0365), enrolled in UMIN-CTR (No: UMIN000019927), and conducted according to the Declaration of Helsinki.ResultsNo significant differences were seen in overall incidence of postoperative complications (Clavien-Dindo classification IIIa: 37.5% in SR group vs. 62.5% in HAR group; P=0.080), except for postoperative liver abscess formation (P=0.020). Five-year overall survival rates were 30.3% and 20.4%, respectively. No significant difference in overall survival rate was apparent between the SR and HAR groups (P=0.150).ConclusionDespite being a demanding procedure, concomitant HAR appears feasible for selected patients with perihilar cholangiocarcinoma.