AIM: To investigate the prognostic value of metastaticlymph node ratio(MLNR) in extrahepatic cholangiocarcinoma(ECC) patients undergoing radical resection.METHODS: Seventy-eight patients with ECC were enrolled.Associa...AIM: To investigate the prognostic value of metastaticlymph node ratio(MLNR) in extrahepatic cholangiocarcinoma(ECC) patients undergoing radical resection.METHODS: Seventy-eight patients with ECC were enrolled.Associations between various clinicopathologic factors and prognosis were investigated by KaplanMeier analyses.The Cox proportional-hazards model was used for multivariate survival analysis.RESULTS: The overall three- and five-year survival rates were 47.26% and 23.99%, respectively.MLNR of 0, 0-0.2, 0.2-0.5, and > 0.5 corresponded to fiveyear survival rates of 28.59%, 21.60%, 18.84%, and 10.03%, respectively.Univariate analysis showed that degree of tumor differentiation, lymph node metastasis, MLNR, tumor-node-metastasis(TNM) stage, and margin status were closely associated with postoperative survival in ECC patients(P < 0.05).Multivariate analysis showed that MLNR and TNM stage were independent prognostic factors after pancreaticoduodenectomy(HR = 2.13, 95%CI: 1.45-3.11; P < 0.01; and HR = 1.97, 95%CI: 1.17-3.31; P = 0.01, respectively).The median survival time for MLNR > 0.5, 0.2-0.5, 0-0.2, and 0 was 15 mo, 24 mo, 23 mo, and 35.5 mo, respectively.There were statistical differences in survival time between patients with different MLNR(χ2 = 15.38; P < 0.01).CONCLUSION: MLNR is an independent prognostic factor for ECC patients after radical resection and is useful for predicting postoperative survival.展开更多
Pancreatic tumors, with peri-pancreatic main vascular invasion, especially the superior mesenteric vein(SMV) or the portal vein, are very common. In some cases, vascular resection and reconstruction are required for c...Pancreatic tumors, with peri-pancreatic main vascular invasion, especially the superior mesenteric vein(SMV) or the portal vein, are very common. In some cases, vascular resection and reconstruction are required for complete resection of pancreatic tumors. However, the optimum surgical method for venous management is controversial. Resection of the SMV without reconstruction during surgery for pancreatic tumors is rarely reported. Here we present the case of a 58-year-old woman with a giant pancreatic mucinous cystadenoma adhering to the SMV, who underwent an en bloc tumor resection, including the main trunk of the SMV and the spleen. No venous reconstruction was performed during surgery. No ischemic changes occurred in the bowel. The presence of several welldeveloped collateral vessels was shown by 3-dimensional computed tomography examination. The patient had an uneventful postoperative period and was discharged. This case indicated that the main trunk of the SMV can be resected without venous reconstruction if adequate collateralization has formed.展开更多
文摘AIM: To investigate the prognostic value of metastaticlymph node ratio(MLNR) in extrahepatic cholangiocarcinoma(ECC) patients undergoing radical resection.METHODS: Seventy-eight patients with ECC were enrolled.Associations between various clinicopathologic factors and prognosis were investigated by KaplanMeier analyses.The Cox proportional-hazards model was used for multivariate survival analysis.RESULTS: The overall three- and five-year survival rates were 47.26% and 23.99%, respectively.MLNR of 0, 0-0.2, 0.2-0.5, and > 0.5 corresponded to fiveyear survival rates of 28.59%, 21.60%, 18.84%, and 10.03%, respectively.Univariate analysis showed that degree of tumor differentiation, lymph node metastasis, MLNR, tumor-node-metastasis(TNM) stage, and margin status were closely associated with postoperative survival in ECC patients(P < 0.05).Multivariate analysis showed that MLNR and TNM stage were independent prognostic factors after pancreaticoduodenectomy(HR = 2.13, 95%CI: 1.45-3.11; P < 0.01; and HR = 1.97, 95%CI: 1.17-3.31; P = 0.01, respectively).The median survival time for MLNR > 0.5, 0.2-0.5, 0-0.2, and 0 was 15 mo, 24 mo, 23 mo, and 35.5 mo, respectively.There were statistical differences in survival time between patients with different MLNR(χ2 = 15.38; P < 0.01).CONCLUSION: MLNR is an independent prognostic factor for ECC patients after radical resection and is useful for predicting postoperative survival.
文摘Pancreatic tumors, with peri-pancreatic main vascular invasion, especially the superior mesenteric vein(SMV) or the portal vein, are very common. In some cases, vascular resection and reconstruction are required for complete resection of pancreatic tumors. However, the optimum surgical method for venous management is controversial. Resection of the SMV without reconstruction during surgery for pancreatic tumors is rarely reported. Here we present the case of a 58-year-old woman with a giant pancreatic mucinous cystadenoma adhering to the SMV, who underwent an en bloc tumor resection, including the main trunk of the SMV and the spleen. No venous reconstruction was performed during surgery. No ischemic changes occurred in the bowel. The presence of several welldeveloped collateral vessels was shown by 3-dimensional computed tomography examination. The patient had an uneventful postoperative period and was discharged. This case indicated that the main trunk of the SMV can be resected without venous reconstruction if adequate collateralization has formed.
