Eil Robert, Hansen Paul D, Cassera Maria, Orloff Susan L, Sheppard Brett C, Diggs Brian, Billingsley Kevin G
Division of Surgical Oncology Oregon Health and Sciences University Portland, OR.
Gastrointest Cancer Res. 2013 Jul;6(4):101-5.
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.
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.
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).
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.
胆囊癌（GBC）预后不佳，死亡率高。本回顾性研究旨在确定GBC切除术后的预后因素，以协助选择合适的手术和辅助治疗。
通过病理学鉴定来自两家机构的62例GBC患者。其中25例患者就诊时癌症无法切除。其余37例患者构成研究人群。采用对数秩分析评估与无病生存期（DFS）和疾病特异性生存期（DSS）的单变量关联。采用Cox回归进行多变量分析。
DFS和DSS的中位数分别为22.6个月和28.5个月，中位随访时间为44.2个月。单变量分析显示，胆管（BD）受累与DFS降低（P≤0.001）和DSS降低（P = 0.004）显著相关。BD受累均导致死亡。淋巴结（LN）受累与DFS或DSS无显著关联（P = 0.85，P = 0.54）。
我们研究人群中所有BD受累的患者均死于该疾病。可切除的GBC且BD受累的患者亚组是复发高危人群，应按此进行治疗。在我们的小样本研究中，评估BD受累的术前和术中方法不可靠。
