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胆囊癌治疗方式与生存趋势:基于人群的研究。

Treatment Modality and Trends in Survival for Gallbladder Cancer: a Population-Based Study.

机构信息

School of Nursing, McMaster University, 1280 Main St. West, Room 3N28B, Hamilton, ON, l8S 4K1, Canada.

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.

出版信息

J Gastrointest Cancer. 2021 Mar;52(1):256-262. doi: 10.1007/s12029-020-00397-w.

Abstract

PURPOSE

There are only a few reports on the treatment-based survival of gallbladder cancer (GBC). The primary objective of this study was to examine the change in treatment modality and the related trends in the survival of GBC.

METHODS

This study includes all cases of primary GBC diagnosed in the province of Ontario, Canada, from January 2007 to December 2015 with known disease stage. Treatment modalities were classified as no treatment, radiation or chemotherapy, and surgical resection. We examined the association between surgical resection and demographics and tumor characteristics and estimated the trends in survival based on treatment modality.

RESULTS

In total, 564 patients with GBC were identified, of which 374 (66.3%) were female. Although there were no significant trends in treatment modalities over the study period (p = 0.276), survival rates improved for all treatment modalities over time. There was a 35% increase in 5-year survival for the surgical resection group from 2007 to 2015. For patients with stage I-II disease, the 5-year survival rate increased 40% over time. The highest 5-year survival was observed for the surgical resection group in patients with stage I-II disease (0.533 (95% CI, 0.514-0.552)) while the average 5-year survival rate for all patients over the study period was 0.247 (95% CI, 0.228-0.266).

CONCLUSIONS

Most cases of GBC continue to be diagnosed in the late stage. Five-year survival for the surgical resection group has markedly improved over time, specifically for patients with stage I-II disease which increased from 30% in 2007 to 70% in 2015.

摘要

目的

仅有少数关于胆囊癌(GBC)治疗基础生存的报告。本研究的主要目的是检查 GBC 治疗方式的变化及其相关的生存趋势。

方法

本研究包括 2007 年 1 月至 2015 年 12 月期间在加拿大安大略省诊断的所有原发性 GBC 病例,且均已知疾病分期。治疗方式分为未治疗、放疗或化疗以及手术切除。我们检查了手术切除与人口统计学和肿瘤特征之间的关联,并根据治疗方式估计了生存趋势。

结果

共确定了 564 例 GBC 患者,其中 374 例(66.3%)为女性。尽管研究期间治疗方式没有明显趋势(p=0.276),但所有治疗方式的生存率随时间推移而提高。手术切除组的 5 年生存率从 2007 年到 2015 年增加了 35%。对于 I 期-II 期疾病患者,5 年生存率随时间增加了 40%。在 I 期-II 期疾病患者中,手术切除组的 5 年生存率最高(0.533(95%CI,0.514-0.552)),而在整个研究期间所有患者的平均 5 年生存率为 0.247(95%CI,0.228-0.266)。

结论

大多数 GBC 病例仍在晚期诊断。手术切除组的 5 年生存率随时间明显提高,尤其是 I 期-II 期疾病患者,从 2007 年的 30%增加到 2015 年的 70%。

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