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胆囊癌患者的回顾性分析:根据肿瘤分期的手术治疗及生存情况

A retrospective analysis of patients with gallbladder cancer: surgical treatment and survival according to tumor stage.

作者信息

Justo Iago, Marcacuzco Alberto, Nutu Oana-Anisa, Manrique Alejandro, Calvo Jorge, Caso Óscar, Cambra Félix, García-Sesma Álvaro, Jiménez-Romero Luis Carlos

机构信息

Cirugia general, Hospital Universitario 12 de Octubre.

Cirugia general , Hospital Universitario 12 de Octubre , España.

出版信息

Rev Esp Enferm Dig. 2018 Aug;110(8):485-492. doi: 10.17235/reed.2018.5435/2017.

Abstract

INTRODUCTION

gallbladder cancer is the most common biliary neoplasm and the sixth most common tumor of the digestive system. The disease has an ominous prognosis, with a 5-year survival rate of approximately 5%. It is usually diagnosed late and surgical resection is the only potential cure.

METHODS

a retrospective study was carried out in 92 patients with a pathological diagnosis of gallbladder cancer from January 2000 to January 2016.

RESULTS

the mean age of cases was 72 ± 11 years; 64 subjects were females and 28 were males. Symptoms at admission included abdominal pain (78%), anorexia (77%), nausea (76%) and jaundice (45%). Surgery was indicated in 92 (100%) patients and 59 (64%) underwent a curative/intent resection. The initial surgical procedures included simple cholecystectomy in 69 (75%) cases and extended cholecystectomy in eleven (11%) subjects. Rescue surgery was performed in 15 patients with tumor tissue in the cholecystectomy specimen; ten individuals underwent an R0 curative resection. Adjuvant therapy was administered in 30 (33%) patients. The median survival in our series was 12.5 months, with survival rates of 57%, 30% and 20% at one, three and five years, respectively.

CONCLUSION

to conclude, surgical treatment with a complete tumor resection should be considered for all patients, provided that their clinical status allows it.

摘要

引言

胆囊癌是最常见的胆道肿瘤,也是消化系统第六大常见肿瘤。该疾病预后不佳,5年生存率约为5%。它通常在晚期才被诊断出来,手术切除是唯一可能的治愈方法。

方法

对2000年1月至2016年1月间92例经病理诊断为胆囊癌的患者进行回顾性研究。

结果

病例的平均年龄为72±11岁;64例为女性,28例为男性。入院时的症状包括腹痛(78%)、厌食(77%)、恶心(76%)和黄疸(45%)。92例(100%)患者均接受了手术治疗,其中59例(64%)接受了根治性/意向性切除。初始手术方式包括单纯胆囊切除术69例(75%)和扩大胆囊切除术11例(11%)。15例胆囊切除标本中有肿瘤组织的患者接受了挽救性手术;10例患者接受了R0根治性切除。30例(33%)患者接受了辅助治疗。我们系列研究中的中位生存期为12.5个月,1年、3年和5年的生存率分别为57%、30%和20%。

结论

总之,对于所有患者,只要其临床状况允许,均应考虑进行完整肿瘤切除的手术治疗。

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