Department of Hepatobiliary and Pancreatic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Department of Biliary-Pancreatic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
J Dig Dis. 2022 Mar;23(3):166-173. doi: 10.1111/1751-2980.13088. Epub 2022 Mar 15.
Primary gallbladder neuroendocrine carcinomas (GB-NEC) are malignant neoplasms that remained to be studied. In this study we aimed to summarize their clinicopathological characteristics, effective treatment and prognostic factors for patients with GB-NEC.
Patients with GB-NEC admitted to Shanghai Jiao Tong University Affiliated Sixth People's Hospital and Renji Hospital, School of Medicine, Shanghai Jiao Tong University from October 2012 to August 2020 were enrolled. Clinicopathological characteristics of our patients and those reported in previous studies were recorded. The Kaplan-Meier method and univariate and multivariate Cox regression analyses were used for survival analysis.
Altogether 15 patients from our hospitals and 47 patients from previous studies were included. A total of 55 patients who underwent surgical resection, including R and non-R resection, had significantly longer overall survival compared with the other seven patients. A univariate analysis indicated that patients aged 60 years or older, with jaundice, carcinoid syndrome, non-R resection, and advanced stage were associated with worse survival. A multivariate analysis showed that patients aged 60 years or older, carcinoid syndrome and non-R resection, but not lymphadenectomy and adjuvant chemotherapy, were independently related to reduced survival.
R resection should be the first-line treatment for GB-NEC. Older age, carcinoid syndrome and non-R resection are independently associated with reduced survival after surgical resection.
原发性胆囊神经内分泌癌(GB-NEC)是一种恶性肿瘤,仍需进一步研究。本研究旨在总结其临床病理特征、有效治疗方法及预后因素。
纳入 2012 年 10 月至 2020 年 8 月期间上海交通大学附属第六人民医院和上海交通大学医学院附属仁济医院收治的原发性胆囊神经内分泌癌患者。记录患者的临床病理特征,并与既往研究报道的病例进行汇总分析。采用 Kaplan-Meier 法和单因素及多因素 Cox 回归分析进行生存分析。
共纳入我院 15 例和既往研究 47 例患者,共 55 例行手术切除患者(包括 R 及非 R 切除术),总生存时间明显长于其他 7 例未手术患者。单因素分析显示,年龄 60 岁及以上、黄疸、类癌综合征、非 R 切除术及晚期是影响生存的不良因素。多因素分析显示,年龄 60 岁及以上、类癌综合征及非 R 切除术,而非淋巴结清扫术和辅助化疗与生存时间缩短独立相关。
R 切除术应作为原发性胆囊神经内分泌癌的首选治疗方法。年龄较大、类癌综合征和非 R 切除术与手术切除后的生存时间缩短独立相关。