Pais-Costa Sergio Renato, Farah José Francisco de Matos, Artigiani-Neto Ricardo, Franco Maria Isete Fares, Martins Sandro José, Goldenberg Alberto
Hospital Francisco Morato de Oliveira, FMO, HSPE, São Paulo, SP, Brazil.
Arq Bras Cir Dig. 2012 Jan-Mar;25(1):13-9. doi: 10.1590/s0102-67202012000100004.
In spite its relative rarity, gallbladder adenocarcinoma is a neoplasm who presents an aggressive biologic behavior. The single curative treatment has been radical surgical resection with free margin. Prognostic factors has been studied because are very important to identify long-term survival patients which may benefit of aggressive surgical resection.
To evaluate long-term prognostic predictors from gallbladder cancer.
The medical records of all patients that presented confirmed histological diagnosis of gallbladder adenocarcinoma operated over a 14 year period were identified and retrospectively reviewed. Uni and multivariate analysis was done.
Total sample was 100 patients. Median age was 71 years (34 to 93). There were 17 men and 83 women. Lesion distribution according to TNM stage system was: I (n=22), II (n=59), III (n=6), IV (n=4) and unknown (n=9). Fifty two patients underwent radical resection (R0) while 48 to palliative surgery (R1-R2). Overall major morbidity was 14%, while postoperative surgical mortality rate (30th postoperative day) was 12 %. Five-year survival rate was 28% while median of survival was 10 months. Multivariate analysis identified six prognostic factors: T stage, serum level of CA 19.9, gallbladder perforation, lymphatic embolization, surgical historical cohort (after 2002) and hilar lymphadenectomy.
Prognostic factors were: T stage, serum level of CA 19.9, gallbladder perforation, lymphatic embolization, surgical historical cohort and hilar lymphadenectomy.
尽管胆囊腺癌相对罕见，但它是一种具有侵袭性生物学行为的肿瘤。唯一的根治性治疗方法是进行切缘阴性的根治性手术切除。由于确定可能从积极手术切除中获益的长期生存患者非常重要，因此对预后因素进行了研究。
评估胆囊癌的长期预后预测因素。
确定并回顾性分析了14年间所有经组织学确诊为胆囊腺癌并接受手术治疗患者的病历。进行了单因素和多因素分析。
总样本为100例患者。中位年龄为71岁（34至93岁）。男性17例，女性83例。根据TNM分期系统，病变分布为：I期（n = 22），II期（n = 59），III期（n = 6），IV期（n = 4），分期未知（n = 9）。52例患者接受了根治性切除（R0），而48例接受了姑息性手术（R1 - R2）。总体主要发病率为14%，术后手术死亡率（术后第30天）为12%。5年生存率为28%，中位生存期为10个月。多因素分析确定了六个预后因素：T分期、CA 19.9血清水平、胆囊穿孔、淋巴管侵犯、手术历史队列（2002年后）和肝门淋巴结清扫术。
预后因素为：T分期、CA 19.9血清水平、胆囊穿孔、淋巴管侵犯、手术历史队列和肝门淋巴结清扫术。
