Division of Surgical Oncology, Icahn School of Medicine at Mount Sinai St. Luke's Roosevelt Hospital, 425 West 59th Street, Suite 7B, New York, NY, 10019, United States.
Division of Surgical Oncology, Icahn School of Medicine at Mount Sinai St. Luke's Roosevelt Hospital, 425 West 59th Street, Suite 7B, New York, NY, 10019, United States.
Am J Surg. 2020 Nov;220(5):1242-1248. doi: 10.1016/j.amjsurg.2020.06.050. Epub 2020 Jul 1.
Although gallbladder adenocarcinoma (AC) is potentially curable with resection, outcomes of squamous histologies are poorly described.
We retrospectively analyzed all gallbladder cancers which underwent resection-for-cure in our health system from 2007 to 2017. We compared outcomes of AC to adeno-squamous (ASC)/squamous (SC) histologies.
91 patients met criteria; 76 AC, 15 ASC/SC. Compared to AC, ASC/SC tumors were larger (58 vs. 28 mm), with more frequent liver invasion (73% vs. 37%), pN+ (60% vs. 32%), higher stage (III/IV 73% vs. 52%), and displayed more LVI (60% vs. 36%), p < 0.05. For stage III/IV disease, provided R0 was achieved, survival was durable and similar for ASC/SC and AC (OS median 28mo ASC/SC vs. 25mo AC, p = 0.132; PFS median 21mo ASC/SC vs. 13mo AC, p = 0.206). Pure SC had considerably poorer median OS (<5mo) than ASC (23mo) and AC (28mo).
Squamous variants of gallbladder cancer confer aggressive and advanced disease and often require more radical resections to achieve R0. Durable survival is possible in ASC provided R0 is achieved. Pure SC has dismal survival even with R0 resection.
尽管胆囊腺癌（AC）通过切除具有潜在的可治愈性，但鳞状组织学的结果描述较差。
我们回顾性分析了 2007 年至 2017 年在我们的医疗系统中接受根治性切除的所有胆囊癌患者。我们比较了 AC 与腺鳞（ASC）/鳞状（SC）组织学的结果。
91 例患者符合标准；76 例 AC，15 例 ASC/SC。与 AC 相比，ASC/SC 肿瘤更大（58 与 28mm），更频繁发生肝侵犯（73%与 37%），pN+（60%与 32%），更高分期（III/IV 期 73%与 52%），并且 LVI 更多（60%与 36%），p<0.05。对于 III/IV 期疾病，只要达到 R0，生存是持久的，ASC/SC 和 AC 的生存相似（OS 中位值 ASC/SC 为 28 个月，AC 为 25 个月，p=0.132；PFS 中位值 ASC/SC 为 21 个月，AC 为 13 个月，p=0.206）。纯 SC 的中位 OS（<5 个月）明显低于 ASC（23 个月）和 AC（28 个月）。
胆囊癌的鳞状变体具有侵袭性和晚期疾病特征，通常需要更激进的切除才能达到 R0。如果达到 R0，ASC 是可以获得持久生存的。即使达到 R0 切除，纯 SC 的生存也很渺茫。
