Multi-Center Study on Gender Difference in Resectability and Pathologic Prognosis of Gallbladder Cancer

Yang Tae Park, J. Kang, Jae Seon Kim, M. Jung, S. Kim, Jaehee Cho, S. Woo, K. Lee, E. Kim, Hyo Jung Kim
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Abstract

Background/Aim: In gallbladder cancer (GBC), gender differences in incidence and mortality rates have been reported with geographic variation. However, there is little known about sex-related difference in GBC prognosis. This study compares prognostic factors according to gender for GBC.Methods: We searched clinicopathological factors in all stages of 952 GBC patients from seven medical centers in Korea. A total of 927 patients were enrolled and surgery with curative resection was performed in 499 patients.Results: Carbohydrate antigen (≥37 U/mL) was a significant prognostic factor in both females and males (odd ratio [OR], 4.30; 95% confidence interval [CI], 3.13-5.89; p<0.001). Age was a significant factor only in female patients, elderly patients were associated with low resectability and the likelihood of T-stage >2; an independent predictor of poor prognosis via multivariate analysis (OR, 1.03; 95% CI, 1.01-1.05; p=0.005, OR, 1.05; 95% CI, 1.02-1.08; p=0.002). Body mass index (BMI) also showed gender difference, and lower BMI (≤25 kg/m2) was the significant good indicator of multivariate analysis for lymph node metastasis in female patients (OR, 0.42; 95% CI, 0.23-0.77; p=0.005) but, the significant poor indicator of univariate analysis for advanced T-stage in male (OR, 2.79; 95% CI, 1.40-5.54; p=0.003).Conclusions: These results suggest that there is a possibility of gender difference in GBC prognosis. Age and high BMI were poor prognostic factors for curative resection for female GBC patients.
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胆囊癌可切除性及病理预后的性别差异多中心研究
背景/目的:在胆囊癌(GBC)中,已经报道了发病率和死亡率的性别差异和地理差异。然而,对GBC预后的性别差异知之甚少。本研究根据性别比较GBC的预后因素。方法:我们检索了韩国7个医疗中心952例GBC患者各阶段的临床病理因素。共纳入927例患者,其中499例患者行根治性手术切除。结果:碳水化合物抗原(≥37 U/mL)是女性和男性的重要预后因素(奇比[OR], 4.30;95%置信区间[CI], 3.13-5.89;p2;多因素分析显示预后不良的独立预测因子(OR, 1.03;95% ci, 1.01-1.05;p=0.005, OR, 1.05;95% ci, 1.02-1.08;p = 0.002)。体重指数(BMI)也存在性别差异,较低的BMI(≤25 kg/m2)是女性患者淋巴结转移多因素分析的显著良好指标(OR, 0.42;95% ci, 0.23-0.77;p=0.005),但男性晚期t期单变量分析指标显著较差(OR, 2.79;95% ci, 1.40-5.54;p = 0.003)。结论:提示GBC预后可能存在性别差异。年龄和高BMI是女性GBC患者根治性切除的不良预后因素。
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