Gupta Sameer, Prakash Puneet, Kumar Vijay, Chaturvedi Arun, Misra Sanjeev, Akhtar Naseem, Rajan Shiv, Agarwal Preeti, Smith Lynette M, Are Chandrakanth
Department of Surgical Oncology, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India.
AIIMS, Jodhpur, Rajasthan, India.
J Surg Oncol. 2022 Mar;125(4):631-641. doi: 10.1002/jso.26766. Epub 2021 Dec 11.
Gallbladder cancer (GBC) is an aggressive malignancy where curative resection is possible in few and survival is poor. There are limited data on outcomes in patients with de novo GBC from endemic regions undergoing surgery for curative intent. We report survival outcomes in this group of patients from a region with high incidence of disease.
We reviewed the records of all GBC patients (2014-2018) and included those who underwent radical cholecystectomy (RC) for de novo GBC. Univariable and multivariable analyses were performed to identify factors influencing recurrence and survival.
A total of 649 patients with GBC were evaluated for surgery and curative intent surgery was attempted in 246 (38%) patients. Of these 246 patients, RC was performed in 115 patients, with histologically confirmed de novo GBC. Locally advanced disease (≥stage IIIB) was present in 52 (45.2%) patients. Median time to recurrence and overall survival (OS) were 31 and 36 months, respectively. Lymph node positivity (p = 0.005) and grade significantly influenced OS on multivariable analysis.
Satisfactory survival outcomes are possible after RC for de novo GBC. Extended resections performed in high volume centers combined with appropriate adjuvant treatment can offer significant survival benefits, with acceptable morbidity and mortality rates.
胆囊癌（GBC）是一种侵袭性恶性肿瘤，很少能进行根治性切除，生存率较低。关于来自地方病流行地区的初发性GBC患者接受根治性手术的预后数据有限。我们报告了来自该病高发地区的这组患者的生存结果。
我们回顾了所有GBC患者（2014 - 2018年）的记录，并纳入了那些因初发性GBC接受根治性胆囊切除术（RC）的患者。进行单变量和多变量分析以确定影响复发和生存的因素。
共有649例GBC患者接受了手术评估，246例（38%）患者尝试进行了根治性手术。在这246例患者中，115例患者进行了RC，组织学确诊为初发性GBC。52例（45.2%）患者存在局部晚期疾病（≥IIIB期）。复发的中位时间和总生存期（OS）分别为31个月和36个月。多变量分析显示，淋巴结阳性（p = 0.005）和分级对OS有显著影响。
初发性GBC患者接受RC后可能获得满意的生存结果。在高容量中心进行扩大切除术并结合适当的辅助治疗可带来显著的生存益处，且发病率和死亡率可接受。
