胆囊癌切除后累及胆管预示预后不良。

Robert Eil, Paul D Hansen, Maria Cassera, Susan L Orloff, Brett C Sheppard, Brian Diggs, Kevin G Billingsley
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引用次数: 0

摘要

背景:胆囊癌(GBC)预后不良,死亡率高。本回顾性研究旨在确定GBC切除术后的预后因素,以帮助选择合适的手术和辅助治疗。方法:对来自两所医院的62例GBC患者进行病理鉴定。在25例中,癌症在出现时无法切除。其余37例患者构成研究人群。Log-rank分析用于评估与无病生存期(DFS)和疾病特异性生存期(DSS)的单变量关联。多因素分析采用Cox回归。结果:中位DFS和DSS分别为22.6和28.5个月,中位随访时间为44.2个月。单因素分析显示,胆管受损伤与DFS (P≤0.001)和DSS (P = 0.004)降低显著相关。双相障碍均是致命的。LN受累与DFS或DSS无显著相关性(P = 0.85, P = 0.54)。结论:本组所有BD患者均死于该病。可切除的GBC和BD患者亚群是复发风险高的群体,应该这样治疗。在我们的小范围人群中,术前和术中评估BD受累的方法是不可靠的。
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Bile duct involvement portends poor prognosis in resected gallbladder carcinoma.

Background: Gallbladder cancer (GBC) carries an unfavorable prognosis with high mortality. This retrospective study was conducted to identify prognostic factors after resection of GBC, to assist in selecting appropriate surgical and adjuvant therapy.

Methods: Sixty-two patients from two institutions were identified with GBC by pathology. In 25, the cancer was unresectable at presentation. The remaining 37 patients comprised the study population. Log-rank analysis was used to assess univariate association with disease-free survival (DFS) and disease-specific survival (DSS). Cox regression was used for multivariate analysis.

Results: Median DFS and DSS were 22.6 and 28.5 months respectively, with a median follow-up of 44.2 months. On univariate analysis, bile duct (BD) involvement was significantly associated with decreased DFS (P ≤ .001) and DSS (P = .004). BD involvement was uniformly fatal. LN involvement was not significantly associated with DFS or DSS (P = .85, P = .54).

Conclusions: All patients with BD involvement in our population died of the disease. The subset of patients with resectable GBC and BD involvement is a group that is at high risk for recurrence and should be treated as such. In our small population, preoperative and intraoperative methods evaluating BD involvement were unreliable.

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