Kiran R P, Pokala N, Dudrick S J
Department of Surgery, Saint Mary's Hospital, Waterbury, CT, United States.
Ann Surg Oncol. 2007 Feb;14(2):827-32. doi: 10.1245/s10434-006-9224-4. Epub 2006 Nov 16.
Little is known about the trends in the incidence, survival, and treatment patterns of gallbladder cancer over the last decade.
Data of patients in the Surveillance, Epidemiology and End Results Program of the National Cancer Institute (SEER 13) with a diagnosis of primary gallbladder cancer from 1973-2002 were examined. The effect of surgery and radiotherapy on survival was examined. Incidence of disease, survival, use of surgery, and radiotherapy for patients diagnosed between 1993 and 2002 (Group B) were compared to the others (Group A).
Median age of the 10301 included patients was 73. 72.4% were female and median survival was 4 months. SEER histologic stage was classified as localized (23.7%), regional (37.4%), and distant (38.9%) patients. Median survival for these stages was 20 months, 5 months, and 2 months, respectively. 81.5% patients underwent surgery and 13.3% radiotherapy. Median survival of patients undergoing surgery was significantly longer (8 versus 2 months, P < 0.0001). Radiotherapy in addition to surgery was associated with prolonged survival for patients with regional and distant stages but not localized stage. Over the 3 decades, the incidence of gallbladder cancer gradually decreased in patients older than 50 years, but increased in younger patients. Significantly fewer Group B patients underwent surgery compared with Group A (74.6% versus 89.9%, P < .001). However, the use of radiotherapy was higher in Group B (14.5% versus 12.4%, P < 0.01).
Over the last decade, the incidence of gallbladder cancer has reduced in patients older than 50 years with an increased incidence in younger patients. Survival of patients has also improved over the last decade. The number of patients undergoing surgery has reduced with an increase in the use of radiotherapy.
过去十年间，胆囊癌的发病率、生存率及治疗模式的变化趋势鲜为人知。
对美国国立癌症研究所监测、流行病学和最终结果计划（SEER 13）中1973年至2002年诊断为原发性胆囊癌的患者数据进行研究。分析手术和放疗对生存的影响。将1993年至2002年诊断的患者（B组）与其他患者（A组）在疾病发病率、生存率、手术及放疗使用情况方面进行比较。
纳入研究的10301例患者中位年龄为73岁。女性占72.4%，中位生存期为4个月。SEER组织学分期分为局限性（23.7%）、区域性（37.4%）和远处转移（38.9%）。这些分期的中位生存期分别为20个月、5个月和2个月。81.5%的患者接受了手术，13.3%接受了放疗。接受手术患者的中位生存期显著更长（8个月对2个月，P < 0.0001）。手术联合放疗可使区域性和远处转移期患者而非局限性期患者生存期延长。在这三十年中，50岁以上患者胆囊癌发病率逐渐下降，但年轻患者发病率上升。与A组相比，B组接受手术的患者明显更少（74.6%对89.9%，P <.001）。然而，B组放疗使用率更高（14.5%对12.4%，P < 0.01）。
在过去十年中，50岁以上患者胆囊癌发病率下降，年轻患者发病率上升。过去十年患者生存率也有所提高。接受手术的患者数量减少，放疗使用率增加。
