关键词: 肝门部胆管癌, 预后, 危险因素, 病理分化程度, 神经侵犯

Abstract: Objective To explore the factors which influence long-term prognosis after operation of hilar cholangiocarcinoma. Methods Forty-nine patients of hilar cholangiocarcinoma underwent surgical treatment were analyzed retrospectively from January 2011 to December 2017 in Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University. Overall survival rates were evaluated based on follow-up results, and risk factors were analyzed. Results The overall 1-year, 3-year and 5-year survival rates were 87.3%,30.8% and 6.2% respectively. The median survival time was 29 months. Single factor analysis showed that neurological invasion, tumor differentiation and percutaneous transhepatic cholangic drainage (PTCD) may be the risk factors. COX proportional hazard model analysis showed that neurological invasion was an independent risk factors affecting prognosis of patients, as well as that of tumor differentiation (P<0.05). The 1-year, 3-year and 5-year survival rates of patients with and without nerve invasion were 77.2%,7.7%,7.5% and 100%,58.4% and 11.8%, respectively. The 1-year, 3-year and 5-year survival rates of patients with high, medium and low differentiation were 100%,54.1%,13.4%,100%,19.9%,0 and 68.8%,14.1% and 0, respectively. Conclusion The overall prognosis of patients with hilar cholangiocarcinoma is poor, and the low degree of differentiation and associated nerve invasion are independent risk factors.

Key words: hilar cholangiocarcinoma, prognosis, risk factor, pathological differentiation degree, nerve invasion