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意外胆囊癌同期根治性切除术与挽救性根治性切除术预后的比较

A Comparison Between the Prognosis of Simultaneous and Salvage Radical Resection in Incidental Gallbladder Cancer.

作者信息

He Shilin, Yu Tunan, Khadaroo Parikshit Asutosh, Cai Liuxin, Chu Yeyuan, Wei Fangqiang, Liang Xiao

机构信息

Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China.

Monash University, School of Medicine, Nursing and Health Sciences, Melbourne, Australia.

出版信息

Cancer Manag Res. 2020 Dec 30;12:13469-13478. doi: 10.2147/CMAR.S286292. eCollection 2020.

Abstract

PURPOSE

Incidental gallbladder cancer (IGBC) is defined as gallbladder cancer (GBC) that is accidentally discovered during cholecystectomy to treat benign lesions. We aimed to compare the prognosis of IGBC patients who underwent simultaneous radical resection (SIR) vs salvage radical resection (SAR).

PATIENTS AND METHODS

We retrospectively reviewed data for IGBC patients admitted to Sir Run Run Shaw Hospital from January 2000 to May 2016. Survival analysis was performed using Kaplan-Meier (univariate) and COX regression (multivariate) analyses.

RESULTS

Eighty-four patients with IGBC underwent radical resection; 43/84 underwent SIR, and 41/84 underwent SAR. Compared with SIR, the SAR group was more likely to receive comprehensive preoperative radiographic evaluation, port-site excision, and have more lymph nodes excised (all P < 0.05). Kaplan-Meier analysis indicated that the prognosis in the SAR group was better than that in SIR (overall survival: P = 0.050, recurrence-free survival: P = 0.028). Regression analysis indicated that the type of radical resection (SIR/SAR) was not an independent prognostic factor (overall survival: P = 0.737, recurrence-free survival: P = 0.957).

CONCLUSION

Patients undergoing SAR had non-inferior survival compared with SIR. It is possible that patients in SAR underwent preoperative radiographical evaluations more comprehensively and the surgical operations were more well performed.

摘要

目的

意外胆囊癌(IGBC)定义为在胆囊切除术治疗良性病变过程中意外发现的胆囊癌(GBC)。我们旨在比较接受同期根治性切除术(SIR)与挽救性根治性切除术(SAR)的IGBC患者的预后。

患者与方法

我们回顾性分析了2000年1月至2016年5月在邵逸夫医院收治的IGBC患者的数据。采用Kaplan-Meier(单因素)和COX回归(多因素)分析进行生存分析。

结果

84例IGBC患者接受了根治性切除术;43/84例接受了SIR,41/84例接受了SAR。与SIR相比,SAR组更有可能接受全面的术前影像学评估、切口部位切除,并且切除的淋巴结更多(所有P<0.05)。Kaplan-Meier分析表明,SAR组的预后优于SIR组(总生存期:P = 0.050,无复发生存期:P = 0.028)。回归分析表明,根治性切除类型(SIR/SAR)不是独立的预后因素(总生存期:P = 0.737,无复发生存期:P = 0.957)。

结论

接受SAR的患者与接受SIR的患者生存率无差异。接受SAR的患者可能术前影像学评估更全面,手术操作更完善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c02/7779289/d0c0098debca/CMAR-12-13469-g0001.jpg

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