是什么消除了治愈的机会:一项关于胆囊癌手术切除后 10 年随访的多中心评估。

IF 4.9 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Annals of medicine Pub Date : 2024-09-12 DOI:10.1080/07853890.2024.2402072
Zuyi Ma,Zhenchong Li,Jiasheng Cao,Jia Sun,Shanzhou Huang,Qi Zhou,Binglu Li
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引用次数: 0

摘要

治愈性切除术是唯一可能治愈胆囊癌(GBC)的方法;然而,有关长期随访数据和阻碍术后治愈的预后因素的知识仍然匮乏。通过分析 2000 年至 2013 年期间三家中国医疗中心经病理证实的 GBC 初次切除病例,我们开展了一项回顾性队列研究。观察治愈的概念是指10年生存期内无任何疾病复发。采用半参数比例危险混合治愈模型可以确定阻碍GBC术后治愈的临床病理因素。在我们目前的研究中,共纳入了 331 例患者,随访时间超过十年。中位总生存期(OS)为 31.6 个月,其中 39 名患者(11.78%)的 OS 达到了 10 年,被归类为 10 年生存者。在这个子集中,有 36 名患者达到了 10 年无复发生存期,即治愈,观察到的治愈率为 10.88%。值得注意的是,合并涉及受侵器官的手术切除、淋巴结转移阳性、R1切除(低于1%)等因素被认为几乎排除了治愈可能。此外,T3-4期、肝脏受侵、AJCC分期晚期或肿瘤分化差的患者获得治愈的可能性较低(低于5%)。这些预后因素的发现对于定制个体化治疗策略和改善临床决策过程具有重要价值。
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What eliminates the chance for cure: a multi-center evaluation on 10-year follow-up of gallbladder cancer after surgical resection.
Curative resection stands as the sole potential cure for gallbladder cancer (GBC); nevertheless, a dearth of knowledge persists regarding long-term follow-up data and prognostic factors that hinder achieving a cure post-surgery. A retrospective cohort study was conducted by analyzing pathologically confirmed initial resections for GBC between 2000 and 2013 across three Chinese medical centers. The concept of observed cure refers to a 10-year survival period devoid of any disease recurrence. Employing a semiparametric proportional hazards mixture cure model enabled the identification of clinicopathological factors impeding a cure for GBC post-surgery. In our current study, a total of 331 patients were included, with a follow-up period exceeding a decade. The median overall survival (OS) was recorded at 31.6 months, with 39 patients (11.78%) achieving a 10-year OS, classified as 10-year survivors. Within this subset, 36 patients reached a 10-year relapse-free survival, denoting cure, and yielding an observed cure rate of 10.88%. Notably, factors such as combined surgical resection involving invaded organs, positive lymph node metastasis, and R1 resection (below 1%) were identified as virtually precluding a cure. Additionally, patients with T3-4 stage, hepatic invasion, advanced AJCC stage or poor tumor differentiation exhibited a low likelihood of achieving cure (below 5%). The discovery of these prognostic factors holds significant value in tailoring individualized treatment strategies and enhancing clinical decision-making processes.
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来源期刊
Annals of medicine
Annals of medicine 医学-医学:内科
CiteScore
4.90
自引率
0.00%
发文量
292
审稿时长
3 months
期刊介绍: Annals of Medicine is one of the world’s leading general medical review journals, boasting an impact factor of 5.435. It presents high-quality topical review articles, commissioned by the Editors and Editorial Committee, as well as original articles. The journal provides the current opinion on recent developments across the major medical specialties, with a particular focus on internal medicine. The peer-reviewed content of the journal keeps readers updated on the latest advances in the understanding of the pathogenesis of diseases, and in how molecular medicine and genetics can be applied in daily clinical practice.
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