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美国胆囊癌:一项基于人群的临床结局研究,涉及监测、流行病学和最终结果数据库(1973 - 2013年)中的22343例患者。

Gallbladder Carcinoma in the United States: A Population Based Clinical Outcomes Study Involving 22,343 Patients from the Surveillance, Epidemiology, and End Result Database (1973-2013).

作者信息

Lau Christine S M, Zywot Aleksander, Mahendraraj Krishnaraj, Chamberlain Ronald S

机构信息

Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, USA.

School of Medicine, Saint George's University, True Blue, Grenada.

出版信息

HPB Surg. 2017;2017:1532835. doi: 10.1155/2017/1532835. Epub 2017 May 30.

Abstract

INTRODUCTION

Gallbladder carcinoma (GBC) is the most common malignancy of the biliary tract and the third most common gastrointestinal tract malignancy. This study examines a large cohort of GBC patients in the United States in an effort to define demographics, clinical, and pathologic features impacting clinical outcomes.

METHODS

Demographic and clinical data on 22,343 GBC patients was abstracted from the SEER database (1973-2013).

RESULTS

GBC was presented most often among Caucasian (63.9%) females (70.7%) as poorly or moderately differentiated (42.5% and 38.2%) tumors, with lymph node involvement (88.2%). Surgery alone was the most common treatment modality for GBC patients (55.0%). Combination surgery and radiation (10.6%) achieved significantly longer survival rates compared to surgery alone (4.0 ± 0.2 versus 3.7 ± 0.1 years, = 0.004). Overall mortality was 87.0% and cancer-specific mortality was 75.4%.

CONCLUSIONS

GBC is an uncommon malignancy that presents most often among females in their 8th decade of life, with over a third of cases presenting with distant metastasis. The incidence of GBC has doubled in the last decade concurrent with increases in cholecystectomy rates attributable in part to improved histopathological detection, as well as laparoscopic advances and enhanced endoscopic techniques. Surgical resection confers significant survival benefit in GBC patients.

摘要

引言

胆囊癌(GBC)是最常见的胆道恶性肿瘤,也是第三常见的胃肠道恶性肿瘤。本研究调查了美国一大群胆囊癌患者,以确定影响临床结局的人口统计学、临床和病理特征。

方法

从监测、流行病学和最终结果(SEER)数据库(1973 - 2013年)中提取了22343例胆囊癌患者的人口统计学和临床数据。

结果

胆囊癌最常发生于白种人(63.9%)女性(70.7%),肿瘤多为低分化或中分化(分别为42.5%和38.2%),伴有淋巴结转移(88.2%)。单纯手术是胆囊癌患者最常见的治疗方式(55.0%)。与单纯手术相比,手术联合放疗(10.6%)的生存率显著更长(4.0 ± 0.2年对3.7 ± 0.1年,P = 0.004)。总死亡率为87.0%,癌症特异性死亡率为75.4%。

结论

胆囊癌是一种不常见的恶性肿瘤,最常发生于80岁左右的女性,超过三分之一的病例出现远处转移。在过去十年中,胆囊癌的发病率翻了一番,同时胆囊切除术的发生率也有所增加,部分原因是组织病理学检测的改善、腹腔镜技术的进步以及内镜技术的提高。手术切除对胆囊癌患者有显著的生存益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6213/5468561/eac68b61ac3d/HPB2017-1532835.001.jpg

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