Clinical Study On The Therapeutic Effects Of Hilar Cholangiocarcinoma By Different Treatments

Hilar cholangiocarcinoma(HCCA)is known as one of the most difficult curable diseases due to its special anatomical location,invasive biological behavior,complex surgical procedures,and poor prognosis.In particularly,there is no standard treatment regimen for those HCCA patients who lost the opportunity for surgical resection.Aims: The aim of this study are to statistically analyze the effects of various treatments regimens for HCCA,especially palliative therapy.The results from our study will provide the guidance for personalized therapy of HCCA patients in the future.Methods: The clinical data of 101 patients with HCCA who were admitted in our center from January 2004 to December 2014 were collected and followed up by December 2016.The patients were divided into 5 groups according to the different treatment methods.Group 1.Radical resection,22 cases;Group 2.Palliative resection,24 cases;Group 3.PTCD,26 cases,Group 4.Biliary stent,16 cases,Group 5.Open surgery biliary drainage,13 cases.The overall survival time,post surgery complications,cost,and the quality of life among these groups were compared and statistical analyzed.Results: The liver functions were restored quickly after treatment at all groups and no statistical differences;More complications of bile infection or bleeding were seen in patients of group 3 and 4.While the postoperative complications in the radical and palliative resection groups were mainly bile leakage,and all of them were healed after extensive drainage.From group 1 to 5,the 1-year survival rates were 95.5%,75.0%,23.1%,25.0%,30.7%,and the 2-year survival rates were 40.9%,16.7%,0,0,0,respectively.3-year survival rates were all 0.(P <0.05).There was significant difference in the radical resection group than the other 4 groups(P <0.05).The papillary resection group was better than groups of PTCD,biliary tract stent,and the open surgery groups,and the difference was significant(P <0.05).There was no significant difference among PTCD,biliary stent,and open surgery group(P > 0.05).Conclusions: Radical resection is the most preferred treatment method for HCCA.The palliative surgery is second considered.While biliary drainage and biliary stent treatment are first choice for those whom the surgical resection were prohibited HCCA patients.Open surgery biliary drainage is no longer recommended due to the higher cost,truma,poor quality of life and survival time,etc.