Analysis of Survival Predictors After Surgical Resection of Hilar Cholangiocarcinoma (HCCC) In a Single Institute With Large Volume
단일 센터에서 시행한 간문부담관암의 수술적 절제후 생존율에 영향을 미치는 인자에 대한 분석
단일 센터에서 시행한 간문부담관암의 수술적 절제후 생존율에 영향을 미치는 인자에 대한 분석
Gi-Won Song, M.D., Sung-Gyu Lee, M.D., FACS, Young-Joo Lee, M.D., Kwang-Min Park, M.D., Shin Hwang, M.D., Ki-Hun Kim, M.D., Chul-Soo Ahn, M.D., Deok-Bog Moon, M.D., Tae-Yong Ha, M.D., Je-Ho Ryu, M.D., Jeong-Ikk Park, M.D., and Hyo- Jun Lee, M.D.
송기원, 이승규, 이영주, 박광민, 황 신, 김기훈, 안철수, 문덕복, 하태용, 류제호, 박정익, 이효준
Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
울산대학교 의과대학 서울아산병원 외 과학교실
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Abstract- Purpose: Although curative resection of hilar cholangiocarcinoma (HCCC) remains a difficultchallenge, only curative resection with tumor free margins can guarantee a favorable outcome.In this report, we retrospectively analyzed the survival data after surgical resection of HCCC todetermine the survival rate and the related factors at a single, large-volume medical institute.Methods: Between June 1989 and June 2005, surgical intervention with curative intent wasperformed on 301 patients. We retrospectively analyzed the survival data via a review of themedical record.Results: Among the 259 cases of resection, curative (R0) resection with tumor-free marginswas achieved in 186 cases (71.8%). Of these 186 cases, 177 patients underwent various typesof hepatectomy with caudate lobectomy and bile duct resection. Combinedpancreatoduodenectomy was performed in 19 patients and portal vein resection was performedin 51 patients. In-hospital mortality developed in 11(4.3%) of the 259 patients who underwentresection. The 1-, 3- and 5-year survival rates of patients who underwent R0 resection were83.3, 42.0 and 29.3%, respectively. Univariate analysis revealed that curability, T stage, lymphnode involvement, histologic differentiation and perineural invasion were associated with patientsurvival. Multivariate analysis showed that curability and lymph node involvement werestatistically significant prognostic factors.Conclusion: Tumor-positive margins and lymph node involvement resulted in poor outcomes.Intensive perioperative management and a surgeon’s aggressive efforts to attain clearance oftumor can minimize the postoperative mortality and maximize survival for patients with HCCC.
- Keywords : hilar cholangiocarcinoma, Klatskin’s tumor, resection, survival rate
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