Prognostic value of lymphovascular invasion in Bismuth-Corlette type Ⅳ hilar cholangiocarcinoma

来源 :World Journal of Gastroenterology | 被引量 : 0次 | 上传用户:chunxi1208
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AIM To assess the prognostic value of lymphovascular invasion(LVI)in Bismuth-Corlette typeⅣhilar cholangiocarcinoma(HC)patients. METHODS A retrospective analysis was performed on 142consecutively recruited typeⅣHC patients undergoing radical resection with at least 5 years of followup.Survival analysis was performed by the KaplanMeier method,and the association between the clinicopathologic variables and survival was evaluated by log-rank test.Multivariate analysis was adopted to identify the independent prognostic factors for overall survival(OS)and disease-free survival(DFS).Multiple logistic regression analysis was performed to determine the association between LVI and potential variables. RESULTS LVI was confirmed histopathologically in 29(20.4%)patients.Multivariate analysis showed that positive resection margin(HR=6.255,95%CI:3.485-11.229,P<0.001),N1 stage(HR=2.902,95%CI:1.132-7.439,P=0.027),tumor size>30 mm(HR=1.942,95%CI:1.176-3.209,P=0.010)and LVI positivity(HR=2.799,95%CI:1.588-4.935,P<0.001)were adverse prognostic factors for DFS.The independent risk factors for OS were positive resection margin(HR=6.776,95%CI:3.988-11.479,P<0.001),N1 stage(HR=2.827,95%CI:1.243-6.429,P=0.013),tumor size>30 mm(HR=1.739,95%CI:1.101-2.745,P=0.018)and LVI positivity(HR=2.908,95%CI:1.712-4.938,P<0.001).LVI was associated with N1 stage and tumor size>30 mm.Multiple logistic regression analysis indicated that N1 stage(HR=3.312,95%CI:1.338-8.198,P=0.026)and tumor size>30 mm(HR=3.258,95%CI:1.288-8.236,P=0.013)were associated with LVI. CONCLUSION LVI is associated with N1 stage and tumor size>30mm and adversely influences DFS and OS in typeⅣHC patients. AIM To assess the prognostic value of lymphovascular invasion (LVI) in Bismuth-Corlette type IV hilar cholangiocarcinoma (HC) patients. METHODS A retrospective analysis was performed on 142 consecutively recruited type IV HC patients undergoing radical resection with at least 5 years of follow up. Survival analysis was performed by the Kaplan Meier method, and the association between the clinicopathologic variables and survival was evaluated by log-rank test. Multivariate analysis was adopted to identify the independent prognostic factors for overall survival (OS) and disease-free survival (DFS). Multiple logistic regression analysis RESULTS LVI was confirmed to be histopathologically in 29 (20.4%) patients. Multivariate analysis showed that positive resection margin (HR = 6.255, 95% CI: 3.485-11.229, P <0.001) (HR = 2.794, 95% CI: 1.176-3.209, P = 0.010) and LVI positivity (HR = 2.902, 95% CI: 1.132-7.439, P = 0.027) 95% CI : 1.588-4.935, P <0.001) were compared with DFS. The independent risk factors for OS were positive resection margin (HR = 6.776,95% CI: 3.988-11.479, P <0.001) , 95% CI: 1.243-6.429, P = 0.013), tumor size> 30 mm (HR = 1.739, 95% CI: 1.101-2.745, P = 0.018) and LVI positivity (HR = 2.908, 95% CI: 1.712- 4.938, P <0.001) .LVI was associated with N1 stage and tumor size> 30 mm.Multiple logistic regression analysis indicated that N1 stage (HR = 3.312, 95% CI: 1.338-8.198, P = 0.026) and tumor size> 30 CONCLUSION LVI is associated with N1 stage and tumor size> 30 mm and adversely influences DFS and OS in type Ⅳ HCV patients. (HR = 3.258, 95% CI: 1.288-8.236, P = 0.013) were associated with LVI.
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