Tumor location influences perioperative and oncologic outcomes in solitary intrahepatic cholangiocarcinoma following curative resection: a multi-center analysis
Tumor location influences perioperative and oncologic outcomes in solitary intrahepatic cholangiocarcinoma following curative resection: a multi-center analysis
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肿瘤位置影响孤立性肝内胆管癌根治性切除后的围手术期和肿瘤学结果：多中心分析
DOI：
10.1016/j.hpb.2022.03.011
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发表时间：
2022-09-23
期刊：
影响因子：
2.9
通讯作者：
Li, Dewei
中科院分区：
文献类型：
--
作者：
Li, Hui;Liu, Rongqiang;Li, Dewei
背景资料：方法：352例ICC患者接受根治性肝切除术，比较不同部位ICC患者的围手术期和肿瘤学结局。比较肿瘤位于包膜下和非包膜下、肝周静脉（pHV）和非pHV、门静脉周围（pPV）和非pPV的ICC患者的临床结局。Kaplan-Meier曲线用于评估肿瘤位置对生存结局的影响。结果：与非pPV相比，pPV ICC的外科手术与更长的手术时间和更高的术中失血量相关。pPV ICC患者与阳性淋巴结（LODDS）分类3-4的对数比值频率增加显著相关。此外，与非pPV相比，位于pPV的ICC与更差的总生存期（OS）和无病生存期（DFS）相关，而在包膜下和非包膜下或pHV和非pHV之间没有观察到显著差异。结论：pPV位置导致孤立性ICC患者接受根治性切除术的围手术期结局差和肿瘤复发快。pPV的位置也有助于区域淋巴结转移，是肝内复发的危险因素。包膜下和pHV位置不影响ICC患者的临床结局。
Background: To compare perioperative and oncologic outcomes of patients with different locations of Methods: A total of 352 ICC patients underwent curative intent hepatectomy were included. Clinical outcomes were compared between ICC patients with tumors located at subcapsular and nonsubcapsular, perihepatic vein (pHV) and non-pHV, or periportal vein (pPV) and non-pPV. Kaplan-Meier curves were used to evaluate the influence of tumor location on survival outcomes. Results: Surgical procedures for pPV ICC were associated with longer operative time and elevated intraoperative blood loss compared to non-pPV. Patients with pPV ICC significantly correlated to increased frequency of log odds of positive lymph nodes (LODDS) classification 3-4. In addition, the ICC located at pPV was correlated with both worse overall survival (OS) and disease-free survival (DFS) compared to non-pPV, whereas no significant difference was observed between subcapsular and nonsubcapsular or between pHV and non-pHV. Conclusions: A pPV location contributed to poor perioperative outcomes and quick tumor recurrence for patients with solitary ICC undergoing curative resection. A pPV location also contributed to regional lymph node metastases and was a risk factor for intrahepatic recurrence. Subcapsular and pHV locations did not influence clinical outcomes of ICC patients.