| Objective:To compare the value among three hilar cholangiocarcinoma(HCC)staging systems,bismuth-corlette typing system,modified T-staging system and Mayo staging system,in predicting the radical resection rate and prognosis of HCC patients.Methods:The clinical data of 138 patients diagnosed as hilar cholangiocarcinoma were retrospectively analyzed.Three different staging methods were used for staging and typing.The chi-square test was used to compare the predictive value of different clinical stages for radical resection rate.Independent risk factors affecting prognosis were determined by Kaplan-Meier and Cox regression.The predictive value of different clinical stages for prognosis was performed by Kaplan-Meier and compared between the two groups.Results:1、With the classification level increased on Bismuth-Corlette classification I,II,III and IV type,the radical resection rate did not significantly decline.The radical resection rates of stage T1、T2 and T3 in modified T-staging system were 60%(27/45),36%(10/28)and 14%(9/65)respectively.The survival time of T1 was longer than T2(P=0.044),T2 longer than T3(P=0.016).The radical resection rate of stage I,II,III and IV in Mayo stage was 86%(12/14),50%(14/28),29%(19/66)and 3%(1/30)respectively.The survival time of I was longer than II(P=0.025),II longer than III(P=0.049),and III significantly longer than IV(P=0.004).2、There was no statistically significant comparison between Bismuth-Corlette and modified T-staging system groups,and the survival analysis curves were crossover;there were differences between the Mayo staging system groups,and the survival analysis curves showed a good parallel decline.The stage I survival time of Mayo stage was longer than that of stage II(P=0.033),stage II was longer than stage III(P=0.013),stage III was significantly longer than stage IV(P=0.000);the median survival time of stage I,II,III and IV was 24,16,10 and 3 months.3、According to univariate and multivariate analyses,surgical mode,lymph node metastasis,distal tumor metastasis and vascular involvement are independent risk factors affecting the prognosis of HCC patients.Conclusion:1、modified T-staging system and Mayo staging system are more accurate than Bismuth-Corlette typing system in predicting radical resection rate in patients with hilar cholangiocarcinoma.2 、 Mayo staging system is superior to Bismuth-Corlette typing system and modified T-staging system in predicting prognosis of patients with hilar cholangiocarcinoma.3、According to univariate and multivariate analyses,surgical mode,lymph node metastasis,distal tumor metastasis and vascular involvement are independent risk factors affecting the prognosis of HCC patients. |
