Hu Liangshuo, Wang Bo, Liu Xuemin, Lv Yi
Department of Hepatobiliary and Pancreas Surgery, The First Affiliated Hospital, Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Arch Iran Med. 2013 Nov;16(11):631-5.
The morbidity of unsuspected gallbladder carcinoma (UGC) has increased. This study was aimed to explore the factors which may influence the therapeutic strategies and prognosis of UCG. Additionally, long-term prognosis of laparoscopic and open surgeries of UGC was comparatively investigated.
Thirty-eight cases of UGC were enrolled in this study. Statistical analysis of survival was performed using the Kaplan-Meier test and the results were examined using the log-rank test.
The morbidity of UGC was 0.43 %. The cancer stagings were: pT1a (one), pT1b (11), pT2 (14), pT3 (10), pT3N1 (one), and pT4 (one). The median lifespan of the entire cohort was 20.0 ± 6.5 months, one-year survival rate was 44 %, and five-year survival rate was 11 %. One-year recurrence- free survival rate was 44 % and three-year recurrence- free survival rate was 0 %. Twenty-eight patients sustained cancer recurrence and three patients sustained port-site cancer recurrence. The cancer staging (P < 0.01) and radical resection (P < 0.01) were independent factors for both overall and recurrence-free survival. Radical resection improved the prognosis of the patients with pT2 stage UGC (P < 0.05), but no significant impact on the prognosis of the patients with pT1b (P = 0.362) or pT3 stage (P = 0.221) UGC. Survival rates were not significantly affected by the first operation no matter it was laparoscopic surgery or open surgery (P = 0.12).
Radical resection surgery is recommended in pT2 stage UGC. There is no difference for the long-term prognosis between laparoscopic surgery (cholecystectomy) and open surgery of UCG.
意外胆囊癌（UGC）的发病率有所上升。本研究旨在探讨可能影响UGC治疗策略和预后的因素。此外，对UGC的腹腔镜手术和开放手术的长期预后进行了比较研究。
本研究纳入了38例UGC患者。采用Kaplan-Meier检验进行生存统计分析，并使用对数秩检验检查结果。
UGC的发病率为0.43%。癌症分期为：pT1a（1例）、pT1b（11例）、pT2（14例）、pT3（10例）、pT3N1（1例）和pT4（1例）。整个队列的中位生存期为20.0±6.5个月，1年生存率为44%，5年生存率为11%。1年无复发生存率为44%，3年无复发生存率为0%。28例患者出现癌症复发，3例患者出现切口部位癌症复发。癌症分期（P<0.01）和根治性切除（P<0.01）是总生存和无复发生存的独立因素。根治性切除改善了pT2期UGC患者的预后（P<0.05），但对pT1b期（P=0.362）或pT3期（P=0.221）UGC患者的预后无显著影响。无论首次手术是腹腔镜手术还是开放手术，生存率均未受到显著影响（P=0.12）。
推荐对pT2期UGC进行根治性切除手术。UGC的腹腔镜手术（胆囊切除术）和开放手术的长期预后没有差异。
