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あるが13)、肝機能を含む背景因子が同一でないために、科学的な評価ができない。すなわち、遠隔成績の上で、系統的切除が部分切除に比し確かに優れているというevidenceはない。科学的評価のためには、無作為比較試験(randomized control trial,RCT)が必要であるが、実際上、系統的切除と部分切除のどちらも対等な条件で可能という症例は少なく、このRCTは現実的ではない。
*1; LN, lymph node metastasis: P, peritonitis and/or pleuritis *2; SAR, Survival After Recurrence (months)*4; NED, no evidence of disease (died of other cause) *5; local recurrence at the surgical margin of bile duct
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図13 胆管細胞癌におけるリンパ節転移の有無別無再発生存率
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肝癌の手術術式
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2003年(平成15年)度後期日本消化器外科学会教育集会
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