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手术切除联合化疗对胆管癌患者生存率的影响:242例病例的多变量分析 被引量:2

Impact of surgical resection combined with chemotherapy on survival of patients with cholangiocarcinoma:a multivariate analysis in a cohort of 242 consecutive patients
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摘要 目的分析手术切除联合化疗对胆管癌患者生存率的影响。方法收集上海交通大学附属瑞金医院2000年2月—2010年11月收治的胆管癌患者242例,对其生存率进行单因素和多因素分析。变量包括患者机能状态、原发肿瘤大小、是否发生远处转移、肿瘤标志物(CA-199)、病理(单发/多发肿瘤)和治疗方法 (手术及化疗)。结果单因素分析结果显示,机能状态、单发或多发肿瘤、原发肿瘤大小、是否发生远处转移、手术与否均是影响胆管癌患者预后的因素(P值均<0.05)。将单因素分析有意义的5个因素纳入COX回归模型进行分析,结果显示机能状态、原发肿瘤大小和手术与否是独立的预后因素(P值均<0.05)。化疗能显著延长生存时间;在手术患者中,联合化疗者的中位生存时间(18.7个月)显著长于未联合化疗者(10.2个月,P=0.03);在未手术患者中,联合化疗者的中位生存时间(9.6个月)显著长于未化疗者(3.1个月,P=0.006)。结论进展期胆管癌患者需行多学科综合治疗,吉西他滨联合草酸铂化疗方案可延长晚期胆管癌患者的生存时间。 Objective To evaluate the related factors of survival rate in patients with cholangiocarcinoma. Methods Univariate and multivariate analysis of variables impacting survival were performed in 242 patients with cholangiocarcinoma between 2000 and 2010. Variables included performance status, tumor size, distant metastasis, tumor markers, pathology, and treatment. Results Univariate analysis showed that performance status, tumor size, distant metastasis, and chemotherapy influenced the prognosis of the patients with cholangiocarcinoma (all P〈O. 05). In multivariate analysis, performance status, tumor size and surgery were independent prognostic factors (all P〈O. 05). Subgroup analysis demonstrated that chemotherapy significantly improved the survival in patients with distant metastasis after total or partial resection (median survival time 18.7 months vs. 10.2 months, P = 0.03) as well as patients who had no surgery (median survival time 9.6 months vs. 3.1 months, P = 0. 006). Conclusion Combined treatment including surgery and chemotherapy is essential for patients with advanced cholangiocarcinoma. And GI chemotherapy can prolong the survival time for late cholangiocarcinoma patients.
出处 《上海医学》 CAS CSCD 北大核心 2011年第11期828-830,共3页 Shanghai Medical Journal
基金 上海市科学委员会重点项目(09JC1410100)
关键词 胆管癌 综合治疗 预后因素 Cholangiocarcinoma combined treatment Prognostic factors
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