Toussi Nima, Daida Krishna, Moser Michael, Le Duc, Hagel Kimberly, Kanthan Rani, Shaw John, Zaidi Adnan, Chalchal Haji, Ahmed Shahid
College of Medicine, University of Saskatchewan, Saskatoon, SK S7N4H4, Canada.
Department of Surgery, University of Saskatchewan, Saskatoon, SK S7N0W8, Canada.
Cancers (Basel). 2024 Aug 23;16(17):2932. doi: 10.3390/cancers16172932.
Gallbladder cancer (GBC) is an uncommon cancer. This study aimed to determine the outcomes of GBC in relation to geographic, demographic, and clinical factors in a Canadian province from 2000 to 2019.
This population-based retrospective cohort study included all patients diagnosed with gallbladder cancer (GBC) in Saskatchewan, Canada, from 2000 to 2019. Cox proportional multivariate regression analysis was conducted to identify factors associated with poorer outcomes.
In total, 331 patients with a median age of 74 years and male-female ratio of 1:2 were identified. Of these patients, 305 (92%) had a pathological diagnosis of GBC. Among patients with documented staging data, 64% had stage IV disease. A total of 217 (66%) patients were rural residents, and 149 (45%) were referred to a cancer center. The multivariate analysis for patients with stage I-III GBC showed that stage III disease [hazard ratio (HR), 2.63; 95% confidence interval (CI), 1.09-6.34)] and urban residence (HR, 2.20; 95% CI, 1.1-4.39) were correlated with inferior disease-free survival. For all patients, stage IV disease (HR, 3.02; 95% CI, 1.85-4.94), no referral to a cancer center (HR, 2.64; 95% CI, 1.51-4.62), lack of surgery (HR, 1.63; 95% CI, 1.03-2.57), a neutrophil-lymphocyte ratio of >3.2 (HR, 1.57; 1.05-2.36), and age of ≥70 years (HR, 1.51; 95% CI, 1.04-2.19) were correlated with inferior overall survival.
In this real-world context, the majority of patients with GBC were diagnosed at a late stage and were not referred to a cancer center. For those with early-stage GBC, living in an urban area and having stage III disease were linked to worse outcomes. Across all stages of GBC, stage IV disease, older age, absence of surgery, lack of referral to a cancer center, and a high neutrophil-to-lymphocyte ratio were associated with poorer survival.
胆囊癌（GBC）是一种罕见的癌症。本研究旨在确定2000年至2019年加拿大一个省份胆囊癌患者的预后与地理、人口统计学和临床因素之间的关系。
这项基于人群的回顾性队列研究纳入了2000年至2019年在加拿大萨斯喀彻温省被诊断为胆囊癌（GBC）的所有患者。进行了Cox比例多变量回归分析，以确定与较差预后相关的因素。
总共确定了331例患者，中位年龄为74岁，男女比例为1:2。在这些患者中，305例（92%）有胆囊癌的病理诊断。在有记录分期数据的患者中，64%患有IV期疾病。共有217例（66%）患者为农村居民，149例（45%）被转诊至癌症中心。对I-III期胆囊癌患者的多变量分析显示，III期疾病[风险比（HR），2.63；95%置信区间（CI），1.09-6.34]和城市居住（HR，2.20；95%CI，1.1-4.39）与无病生存期较差相关。对于所有患者，IV期疾病（HR，3.02；95%CI，1.85-4.94）、未转诊至癌症中心（HR，2.64；95%CI，1.51-4.62）、未进行手术（HR，1.63；95%CI，1.03-2.57）、中性粒细胞与淋巴细胞比值>3.2（HR，1.57；1.05-2.36）以及年龄≥70岁（HR，1.51；95%CI，1.04-2.19）与总生存期较差相关。
在这个现实世界的背景下，大多数胆囊癌患者在晚期被诊断出来，并且没有被转诊至癌症中心。对于早期胆囊癌患者，居住在城市地区和患有III期疾病与较差的预后相关。在胆囊癌的所有阶段，IV期疾病、年龄较大、未进行手术、未转诊至癌症中心以及高中性粒细胞与淋巴细胞比值与较差的生存率相关。
