Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China.
Am Surg. 2023 Apr;89(4):676-684. doi: 10.1177/00031348211038563. Epub 2021 Aug 12.
Chemotherapy is the standard of treatment for metastatic gallbladder carcinoma (GBC). It is unclear whether chemotherapy plus surgery improves the survival outcomes of patients with isolated liver metastases from GBC. We aimed to investigate the survival benefits of chemotherapy plus surgery in GBC with isolated liver metastases compared to those of chemotherapy alone.
We identified 406 patients with isolated liver metastases from GBC who underwent chemotherapy alone or chemotherapy plus surgery between 2010 and 2015 from Surveillance, Epidemiology, and End Results. Patients were divided into 3 subgroups: group I, chemotherapy alone (n = 263); group II, chemotherapy combined with cholecystectomy (n = 116); and group III, chemotherapy combined with cholecystectomy plus hepatectomy (n = 27). The cancer-specific survival and overall survival were evaluated.
Compared with group I, group II revealed a longer survival time (P < .001). In addition, the survival time of the group III was also prolonged (P < .001). Multivariate cox analysis showed that treatment strategy was an independent prognostic factor.
Chemotherapy combined with resection of the primary tumor plus or not plus resection of the metastatic lesions may be beneficial in GBC with isolated liver metastases.
化疗是转移性胆囊癌（GBC）的标准治疗方法。目前尚不清楚化疗加手术是否能改善 GBC 孤立性肝转移患者的生存结局。我们旨在研究与单纯化疗相比，GBC 伴孤立性肝转移患者化疗加手术的生存获益。
我们从 2010 年至 2015 年的监测、流行病学和最终结果中确定了 406 例接受单纯化疗或化疗加手术治疗的 GBC 孤立性肝转移患者。患者被分为 3 个亚组：I 组，单纯化疗（n = 263）；II 组，化疗联合胆囊切除术（n = 116）；III 组，化疗联合胆囊切除术加肝切除术（n = 27）。评估了癌症特异性生存率和总生存率。
与 I 组相比，II 组的生存时间更长（P <.001）。此外，III 组的生存时间也延长了（P <.001）。多因素 cox 分析显示，治疗策略是一个独立的预后因素。
对于 GBC 孤立性肝转移患者，化疗联合切除原发病灶加或不加转移病灶的切除术可能有益。
