胆囊癌患者的手术结果及预后因素

Surgical outcome and prognostic factors in patients with gallbladder carcinoma.

作者信息

Hong Eun Kyung, Kim Kun Kuk, Lee Jung Nam, Lee Woon Kee, Chung Min, Kim Yeon Suk, Park Yeon Ho

机构信息

Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea.

Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.

出版信息

Korean J Hepatobiliary Pancreat Surg. 2014 Nov;18(4):129-37. doi: 10.14701/kjhbps.2014.18.4.129. Epub 2014 Nov 30.

Abstract

BACKGROUNDS/AIMS: Gallbladder carcinoma is usually associated with an unfavorable prognosis, and the clinical outcome has not improved much. This study was conducted to evaluate outcomes with gallbladder carcinoma according to the type of surgery performed, and the prognostic factors for survival.

METHODS

One hundred and six patients with gallbladder carcinoma, who underwent surgery for the purpose of curative resection between January 1999 and June 2012 were reviewed retrospectively.

RESULTS

Out of 106 patients, curative resection was achieved in 75 (70.8%). The cumulative 1-, 2- and 5-year survival rates of the gallbladder carcinoma patients were 93.4%, 80.9% and 63.0%, respectively. Radical resections, including extended cholecystectomy, were more beneficial for long term survival of patients. The 5-year survival rate in patients who underwent curative resection (56.9%) was significantly higher than in those who underwent palliative resection (0%, p=0.000). Multivariate analysis revealed that curative resection, preoperative CA19-9, T-stage, N-stage and differentiation of histology were independently significant prognostic factors.

CONCLUSIONS

Curative resection and early detection of patients with gallbladder carcinoma were the most important factors for long term survival. Radical resection improves survival for patients with localized gallbladder carcinoma and can help to access exact prognosis and treatments.

摘要

背景/目的:胆囊癌通常预后不良,临床结局改善不大。本研究旨在根据所施行的手术类型评估胆囊癌的治疗结果以及生存的预后因素。

方法

回顾性分析1999年1月至2012年6月期间因根治性切除目的而接受手术的106例胆囊癌患者。

结果

106例患者中,75例(70.8%)实现了根治性切除。胆囊癌患者的1年、2年和5年累积生存率分别为93.4%、80.9%和63.0%。包括扩大胆囊切除术在内的根治性切除术对患者的长期生存更有益。接受根治性切除的患者5年生存率(56.9%)显著高于接受姑息性切除的患者(0%,p=0.000)。多因素分析显示,根治性切除、术前CA19-9、T分期、N分期和组织学分化是独立的重要预后因素。

结论

胆囊癌患者的根治性切除和早期发现是长期生存的最重要因素。根治性切除可提高局限性胆囊癌患者的生存率,并有助于准确判断预后和进行治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c83a/4492352/c8eb6fc8ea93/kjhbps-18-129-g001.jpg

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