Cystic duct carcinoma: a proposal for a new "working definition"
Cystic duct carcinoma: a proposal for a new "working definition"
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DOI：
10.1007/s00423-002-0333-7
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发表时间：
2003-01-01
影响因子：
2.3
通讯作者：
Nimura, Y
中科院分区：
文献类型：
--
作者：
Ozden, I;Kamiya, J;Nimura, Y
背景资料：Farrar的胆囊管癌标准（组织病理学诊断严格限于胆囊管癌）有实际局限性。我们提出了新的“工作定义”：胆囊肿瘤，其中心位于胆囊管。患者和方法：1980年至2000年，我们诊断胆囊管癌31例，其中28例（90%）血清胆红素浓度升高。10例患者行肝外胆管切除术和胆囊切除术;其他患者，扩大右肝切除术（16例），右肝切除术（3例）和肝床切除术（2例）也是必要的，以获得潜在的治愈性切除。其他手术包括门静脉切除术（10例）和胰管切除术（7例）。结果：所有肿瘤均为腺癌。3例患者的浸润深度为T2，12例为T3，16例为T4。淋巴结转移13例（42%）。24例患者（77%）进行了根治性切除。住院死亡率为5/31（16%）。不包括住院死亡的5年生存率为22%。结论：建议的“工作定义”避免了与Farrar标准相关的问题，并描述了一个独特的患者组，男性和女性的比例大致相等，晚期T分期，但淋巴结转移的频率低于预期。它为成果的标准报告奠定了基础。
Background: Farrar's criteria for cystic duct carcinoma (histopathological diagnosis of a carcinoma strictly limited to the cystic duct) have practical limitations. We propose new "working definition": a gallbladder tumor, the center of which is located in the cystic duct. Patients and methods: Between 1980 and 2000 we diagnosed cystic duct carcinoma in 31 patients, 28 of whom (90%) had increased serum bilirubin concentrations. Extrahepatic bile duct resection and cholecystectomy were performed in 10 patients; in others, extended right hepatectomy (16), right hepatectomy (3), and liver bed resection (2) were necessary as well for a potentially curative resection. Additional procedures were portal vein resection (10) and pancreatoduodenectomy (7). Results: All tumors were adenocarcinomas. Depth of invasion was T2 in 3 patients, T3 in 12, and T4 in 16. Thirteen patients (42%) had lymph node metastasis. Curative resection was performed in 24 patients (77%). Hospital mortality was 5 of 31 (16%). Actuarial 5-year survival rate excluding hospital deaths was 22%. Conclusions: The proposed "working definition" avoids the problems associated with Farrar's criteria and describes a distinct patient group with an approximately equal proportion of men and women, advanced T stage, but a lower than expected frequency of lymph node metastasis. It establishes a basis for standard reporting of results.