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[目的]探讨影响肝外胆道癌患者的预后因素。[方法]随访68例肝外胆道癌患者,根据临床资料使用单因素生存分析和Cox多元回归进行预后因素的分析。[结果]行根治切除术、单纯切除术和姑息引流术患者的中位总生存期(OS)分别为27个月、16个月和6个月(P=0.001),Ⅲ～Ⅳ期和Ⅰ～Ⅱ期肝外胆道癌患者的中位OS分别为16个月和37个月(P=0.015)。Cox模型发现手术方式(P=0.001)与临床分期(P=0.037)是影响OS的独立预后因素。临床分期为Ⅰ～Ⅱ期肝外胆道癌的中位无复发生存期(RFS)显著长于Ⅲ～Ⅳ期患者(21个月vs.11个月,P=0.003);术后辅助化疗者的中位RFS亦显著高于未化疗者(19个月vs.11个月,P=0.046)。Cox模型证实临床分期(P=0.033)与术后辅助化疗(P=0.038)是影响RFS的独立预后因素。[结论]手术方式与临床分期是肝外胆道癌OS的独立预后因素,而临床分期与是否行辅助化疗为影响RFS的独立预后因素。
[Objective] To investigate the prognostic factors in patients with extrahepatic biliary cancer. [Methods] 68 patients with extrahepatic biliary tract cancer were followed up. The prognostic factors were analyzed by univariate survival analysis and Cox multivariate regression based on clinical data. [Results] The median overall survival (OS) was 27 months, 16 months and 6 months (P = 0.001), Ⅲ ~ Ⅳ and Ⅰ The median OS of patients with stage Ⅱ extrahepatic biliary cancer were 16 months and 37 months, respectively (P = 0.015). The Cox model found that surgery (P = 0.001) and clinical stage (P = 0.037) were independent predictors of OS. The median relapse-free survival (RFS) of patients with stage I-II extrahepatic cholangiocarcinoma was significantly longer than that of patients with stage III-IV (21 months vs. 11 months, P = 0.003); median postoperative adjuvant chemotherapy RFS were also significantly higher than those without chemotherapy (19 months vs. 11 months, P = 0.046). The Cox model demonstrated that clinical stage (P = 0.033) and postoperative adjuvant chemotherapy (P = 0.038) were independent predictors of RFS. [Conclusion] The surgical method and clinical stage are the independent prognostic factors of OS in extrahepatic biliary cancer. However, the clinical stage and whether adjuvant chemotherapy is the independent prognostic factor of RFS.