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Objective To identify the clinicopathologic factors influencing the prognosis of the patients with distal cholangiocarcinoma (dCCA) after radical pancreatoduodenectomy (PD). Methods Retrospectively analyze the clinical data of 231 dCCA post-PD cases in Peking University First Hospital from January 2005 to January 2015. The clinicopathologic parameters were analyzed using univariate and multivariate Cox regression models and Kaplan-Meier method. Results The 1-year, 3-year and 5-year survival rates of the 231 post-PD dCCA patients were 86.6%, 55.0% and 34.6% respectively. Univariate Cox regression analysis showed that the primary tumor invasion depth (T stage) (P=0.000), lymph node metastasis (N stage) (P=0.001), AJCC stage(P=0.000), total number of dissected lymph nodes (P=0.038), metastasis lymph node ratio (P=0.001), vascular tumor thrombus(P=0.001), nerve invasion (P=0.001) and pathological type (P=0.002) were related to the prognosis of patients with dCCA after PD. Multivariate Cox regression analysis showed that the higher degree of lymph node metastasis (P=0.001), total number of lymph nodes dissected ≤10 (P=0.029), positive vascular tumor thrombus (P=0.007), positive nerve invasion (P=0.001) and low differentiation of pathological type (P=0.029) were independent risk factors for poor prognosis of patients with dCCA after PD.Kaplan-Meier analysis showed that the degree of lymph node metastasis, total number of dissected lymph nodes, vascular tumor thrombus, nerve invasion, and pathological type could affect the overall survival (OS) of patients with dCCA after pD (P<0.005), but whether adjuvant chemotherapy or not had no significant effect on OS of positive lymph node metastasis patients with dCCA after PD (P>0.05). Conclusion The higher degree of lymph node metastasis, total number of lymph nodes dissected less than 10, vascular tumor thrombus, nerve invasion and low differentiation of pathological type are considered as the independent poor prognostic factors of post-PD dCCA patients.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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