Lee Sung Ha, Yang Jae Do, Hwang Hong Pil, Yu Hee Chul, Cho Baik Hwan
Department of Surgery, Chonbuk National University Medical School and Hospital, Jeonju, Korea.
Korean J Hepatobiliary Pancreat Surg. 2012 May;16(2):59-64. doi: 10.14701/kjhbps.2012.16.2.59. Epub 2012 May 31.
BACKGROUNDS/AIMS: The aim of this study is to analyze surgical outcomes and prognostic factors affecting survival after surgical resection in patients with gallbladder cancer.
We retrospectively reviewed 86 patients treated surgically for gallbladder cancer from January 2000 to December 2009 at Chonbuk National University Hospital. Clinicopathologic factors, surgical treatment and outcome data were analyzed.
Among the 86 patients (44 male, 42 female) with gallbladder cancer, the mean age was 62.9 years (range: 32-80) and the median survival was 42.4±3.5 month. The overall cumulative survival rates of 86 patients were for 1 year, 83.7%; 3 year, 67.4%; 5 year survival, 61.7%. Univariate analysis revealed that preoperative serum alanine aminotransferase, alkaline phosphatase, total bilirubin, carcinoembryonic antigen (CEA), T staging, N staging were statistically significantly associated with survival. CEA (p=0.004) and T staging (p=0.005) were associated with survival in multivariate analysis. Two-year survival rates were analyzed according to the methods of surgical resection, with simple cholecystectomy showing 100%, whereas extended cholecystectomy showed about 83% in T1b. We could not find out any adverse effect of the simple cholecystectomy for survival.
CEA and T stage are independent significant prognostic factor associated with patient survival in our study. Simple cholecystectomy can be regarded as curative resection in stage T1b. Longer observation periods and more cases will be needed to confirm these conclusions.
背景/目的:本研究旨在分析胆囊癌患者手术切除后的手术结果及影响生存的预后因素。
我们回顾性分析了2000年1月至2009年12月在全北国立大学医院接受手术治疗的86例胆囊癌患者。分析了临床病理因素、手术治疗及结果数据。
86例胆囊癌患者(44例男性,42例女性),平均年龄62.9岁(范围:32 - 80岁),中位生存期为42.4±3.5个月。86例患者的总体累积生存率为:1年,83.7%;3年,67.4%;5年生存率,61.7%。单因素分析显示,术前血清丙氨酸氨基转移酶、碱性磷酸酶、总胆红素、癌胚抗原(CEA)、T分期、N分期与生存有统计学显著相关性。多因素分析中,CEA(p = 0.004)和T分期(p = 0.005)与生存相关。根据手术切除方法分析两年生存率,单纯胆囊切除术显示为100%,而在T1b期扩大胆囊切除术显示约为83%。我们未发现单纯胆囊切除术对生存有任何不良影响。
在我们的研究中,CEA和T分期是与患者生存相关的独立显著预后因素。单纯胆囊切除术可被视为T1b期的根治性切除。需要更长的观察期和更多病例来证实这些结论。