Departments of Hepatopancreatobiliary Surgery.
Breast Surgery, Gansu Wuwei Academy of Medical Science, Wuwei, Gansu Province, China.
Surg Laparosc Endosc Percutan Tech. 2020 Aug;30(4):381-387. doi: 10.1097/SLE.0000000000000789.
The goal of this study was to review relevant randomized controlled trials or case-control studies to determine radical resection compared with simple cholecystectomy for gallbladder carcinoma.
Using appropriate keywords, we identified relevant studies using PubMed, the Cochrane Library, and Embase. Key pertinent sources in the literature were also reviewed, and all articles published through September 2019 were considered for inclusion. For each study, we assessed odds ratios, mean difference, and 95% confidence interval (CI) to assess and synthesize outcomes.
We included 19 studies with a total of 1791 patients in the radical resection group and 3014 in the simple cholecystectomy group. Compared with simple cholecystectomy, radical resection significantly improved the 5-year disease-free survival rate [relative risk (RR): 1.36, 95% CI: 1.02-1.81], the 1-year overall survival (OS) rate (RR: 1.27, 95% CI: 1.04-1.54), and the 3-year OS rate (RR: 1.71, 95% CI: 1.02-2.85). However, there was no significant difference in the recurrence rate (RR: 1.04, 95% CI: 0.87-1.23), and in the 5-year OS rate (RR: 1.05, 95% CI: 0.92-1.19) between the 2 groups.
Compared with simple cholecystectomy, radical resection has advantages in improving the 5-year disease-free survival rate, and the 1- and 3-year OS rate of gallbladder carcinoma patients.
本研究旨在回顾相关的随机对照试验或病例对照研究,以确定与单纯胆囊切除术相比,根治性切除术治疗胆囊癌的效果。
使用适当的关键词,我们通过 PubMed、Cochrane 图书馆和 Embase 确定了相关研究。还对文献中的关键来源进行了综述,并考虑了截至 2019 年 9 月发表的所有文章。对于每项研究,我们评估了优势比、均数差和 95%置信区间(CI),以评估和综合结果。
我们纳入了 19 项研究,其中根治性切除术组共有 1791 例患者,单纯胆囊切除术组有 3014 例患者。与单纯胆囊切除术相比,根治性切除术显著提高了 5 年无病生存率[相对危险度(RR):1.36,95%CI:1.02-1.81]、1 年总生存率(RR:1.27,95%CI:1.04-1.54)和 3 年总生存率(RR:1.71,95%CI:1.02-2.85)。然而,两组间的复发率(RR:1.04,95%CI:0.87-1.23)和 5 年总生存率(RR:1.05,95%CI:0.92-1.19)无显著差异。
与单纯胆囊切除术相比,根治性切除术在提高胆囊癌患者的 5 年无病生存率以及 1 年和 3 年总生存率方面具有优势。