印度北部胆囊癌的临床特点和治疗结果的研究

Amit Sreen, R. Anadure, H. Singh, Rohit Sharma, A. Garg
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引用次数: 2

摘要

目的:胆囊癌(GBC)是印度北部妇女常见的癌症。本前瞻性观察性研究旨在系统研究北印度人群中GBC患者的临床特征、治疗反应和生存模式。材料与方法:研究2013年6月至2015年8月在勒克瑙某三级医院连续就诊的116例经组织学证实的GBC患者的临床特征、疾病分期和治疗结果,随访2年至2017年8月。在预先设计的研究形式中捕获数据,并使用适当的统计工具进行分析。结果:就诊时的中位年龄为60岁,67例患者同时存在胆结石。将患者分为三个治疗组进行分析。A组包括接受根治性胆囊切除术后辅助化疗的患者。B组为接受最佳支持性治疗的患者,C组为接受姑息性化疗的患者。A、B、C组患者的中位总生存期(mOS)分别为16个月、2个月和9个月。无论治疗组如何,所有患者的生存期均为8个月。在单变量分析中,对mOS有不利影响的因素包括梗阻性黄疸、肝酶升高、治疗组和疾病晚期。多因素分析显示,治疗组与mOS有显著相关(P < 0.05)。结论:在我们医院登记的女性中,GBC是第二常见的恶性肿瘤,预后都很差。接受根治性手术和辅助化疗的患者是本研究中存活时间最长的。更好的筛查和早期诊断是改善这种侵袭性恶性肿瘤预后的基石。
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A study on the clinical profile and treatment outcomes in gallbladder carcinoma from Northern India
Aim: Gallbladder carcinoma (GBC) is a common cancer in women in North India. This prospective observational study aimed at systematically studying the clinical features, treatment response, and survival pattern of GBC patients, in a North Indian population. Materials and Methods: The clinical profile, staging of disease, and treatment outcomes of 116 consecutive patients with histologically confirmed GBC, presenting to a tertiary care hospital in Lucknow from June 2013 to August 2015, with a follow-up period of 2 years till August 2017, were studied. Data were captured on a predesigned study proforma and analyzed with appropriate statistical tools. Results: The median age at presentation was 60 years and 67 patients had coexisting gall stones. Patients were divided into three treatment groups for the analysis. Group A comprised patients who underwent radical cholecystectomy followed by adjuvant chemotherapy. Group B included patients who received the best supportive care and Group C consisted of patients who received palliative chemotherapy. The median overall survival (mOS) was 16, 2, and 9 months for Group A, B, and C patients, respectively. The mOS was 8 months for all patients, irrespective of treatment groups. On univariate analysis, factors having an adverse impact on mOS included obstructive jaundice, elevated liver enzymes, treatment groups, and advanced stage of disease. On multivariate analysis, only factor found significantly associated with mOS was treatment group (P < 0.05). Conclusions: GBC was found to be the second most common malignancy among females in our hospital registry with a uniformly poor prognosis. Patients receiving radical surgery and adjuvant chemotherapy were the longest survivors in this study. Better screening and early diagnosis are the cornerstones of improving outcomes in this aggressive malignancy.
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