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Clinical Characteristics and Prognosis Analysis of Advanced Cholan Giocarcinoma

Author: ChenYu
Tutor: ZhangYang
School: Dalian Medical University
Course: Oncology
Keywords: Advanced bile duct Palliative surgery Chemotherapy Chemotherapy BSC
CLC: R735.8
Type: Master's thesis
Year: 2011
Downloads: 34
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Background and Purpose: cholangiocarcinoma is usually already in the late diagnosis, the prognosis is poor, more than 80% of the patients died within 1 year after diagnosis. Radical surgery is the only cure for cholangiocarcinoma means possible to get, but only early surgery can be cured, even if surgery also has a high recurrence rate. For patients with advanced inoperable, chemotherapy, interventional chemotherapy and BSC can improve the patient's quality of life, but there is no standard treatment. This article discusses the clinical features of cholangiocarcinoma, analysis of different treatment methods for advanced bile duct cancer prognosis, provide evidence for the clinical treatment of evidence. Methods: A retrospective analysis of 74 cases of cholangiocarcinoma in patients with advanced clinical data, observation palliative surgery, chemotherapy, interventional chemotherapy and BSC (mainly palliative biliary decompression), the median progression-free survival, median overall survival , 1 year and 1.5-year survival rate. According to palliative surgery treatment, palliative surgery group was divided into postoperative chemotherapy, postoperative interventional chemotherapy, postoperative BSC treatment. According to program different chemotherapy, chemotherapy alone group was divided into 5-FU L-OHP group, GEM combination group and single-agent capecitabine group. In different ways according to the BSC into: PTCD stenting group and PTCD stent group. Application SPSS17.0 statistical software for data processing, using Kaplan-Meier method, log-rank test for statistical analysis, P lt; 0.05 difference was statistically significant. Results: 74 patients, male 48 cases, female 26 cases, male to female ratio was 1.8:1, with a median age of 64.6 years. There were 50 cases of jaundice (67.6%), of which 31 cases of painless jaundice (41.9% of the total, accounting for 62% of the total number of jaundice); upper abdominal pain discomfort 19 cases (25.7%), other clinical manifestations (appetite loss, itching, fatigue, weight loss) 5 cases (7%). Serum bilirubin 65 cases (87.9%), elevated alkaline phosphatase 64 cases (86.5%), γ-GT increased 64 cases (86.5%), ALT, AST increased 70 cases (94.6%). 74 patients underwent tumor markers checked, CEA abnormally elevated 7 cases (9.5%), CA199 abnormally elevated 40 cases (54%), CEA CA199 abnormally elevated 21 cases (28.4%), CEA CA199 normal six cases ( 8.1%). The median progression-free survival comparison: palliative surgery group was 7.0 ± 1.8 months with chemotherapy alone group was 5.0 ± 2.2 months, interventional chemotherapy group was 6.0 ± 3.4 months, BSC group was 1.4 ± 0.4 months (p = 0.000 ). Subgroups palliative palliative surgery postoperative chemotherapy median progression-free survival was 11.0 ± 0.0 months (p = 0.01). Different chemotherapy regimens subgroups no significant difference between, BSC different subgroups was no significant difference between the way the drainage. Four group, the median overall survival comparison: palliative surgery was 11.0 ± 1.9 months with chemotherapy alone group was 13.9 ± 1.3 months, interventional chemotherapy group was 12.0 ± 5.2 months, BSC was 7.0 ± 0.8 months (p = 0.000) . Palliative surgery subgroup subgroup chemotherapy and BSC subgroups did not show statistically significant. Four 1-year survival rates were 31.5%, 10%, 20% and 0%, 1.5-year survival rate of 0%. Conclusion: This study found that receiving palliative surgery combined with chemotherapy in patients with advanced bile duct cancer can be extended median progression-free survival. Chemotherapy' dissertation">Chemotherapy, palliative surgery and interventional chemotherapy extended median progression-free survival and median overall survival considerable effect on, so chemotherapy alone in patients with advanced use, you can avoid surgery and interventional chemotherapy damage to the body. BSC for inoperable, unable to tolerate chemotherapy and interventional treatment of patients with advanced disease, but it can relieve symptoms and improve the patient's quality of life.

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CLC: > Medicine, health > Oncology > Gastrointestinal Cancer > Gallbladder, bile duct cancer
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