Wu Qing-hua, Mo Ling-wei, Zhang Tao, Chen Xue-yu, Zhang Zhuo, Mao Zhi-hai, Jiang Yu, Wang Ming-liang, Zheng Min-hua
Department of General Surgery, Shanghai Jiaotong University School of Medicine, Shanghai Minimally Invasive Surgery Center, Shanghai 200023, China.
Zhonghua Wai Ke Za Zhi. 2010 Jun 1;48(11):812-5.
To investigate the prognostic risk factors in incidental gallbladder cancer (IGBC) and evaluate the effect of laparoscopic cholecystectomy (LC) applied in treating IGBC.
The retrospective study enrolled 55 patients with incidental gallbladder adenocarcinoma treated between January 2001 and December 2008. The patients were divided into three groups according to different surgical approaches: laparoscope group (n = 23), conversion group (n = 6) and laparotomy group (n = 26). Survival analysis and Cox regression model were applied to comparing the difference of survival rate between three groups and to analyzing the related prognostic risk factors of IGBC.
The overall 1-, 3- and 5-year survival rates were 74.3%, 47.7% and 35.8% respectively. And the median survival time was 36 months. The outcome of survival rate between three groups was not different statistically. Cox regression analysis indicated that pathologic T stage was an independent risk factor influencing IGBC (OR = 2.75, P = 0.00). The prognosis was getting worse according to the rising depth of tumor invasion. However, the other factors, such as surgical approach, tumor incisional implantation, ect.were not related to the prognosis (P > 0.05).
The factor of pathologic T stage is related to the prognosis of IGBC for which LC, compared with open cholecystectomy, should not be regarded as a negative factor in treatment.
探讨意外胆囊癌（IGBC）的预后危险因素，并评估腹腔镜胆囊切除术（LC）治疗IGBC的效果。
回顾性研究纳入了2001年1月至2008年12月期间接受治疗的55例意外胆囊腺癌患者。根据不同手术方式将患者分为三组：腹腔镜组（n = 23）、中转组（n = 6）和开腹手术组（n = 26）。应用生存分析和Cox回归模型比较三组生存率的差异，并分析IGBC的相关预后危险因素。
总体1年、3年和5年生存率分别为74.3%、47.7%和35.8%。中位生存时间为36个月。三组生存率结果在统计学上无差异。Cox回归分析表明，病理T分期是影响IGBC的独立危险因素（OR = 2.75，P = 0.00）。随着肿瘤浸润深度增加，预后变差。然而，其他因素，如手术方式、肿瘤切口种植等与预后无关（P > 0.05）。
病理T分期因素与IGBC的预后相关，对于IGBC，与开腹胆囊切除术相比，LC不应被视为治疗中的不利因素。
