Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
HPB (Oxford). 2024 Dec;26(12):1544-1552. doi: 10.1016/j.hpb.2024.09.004. Epub 2024 Sep 13.
The study aimed to investigate the impact of lymph node ratio (LNR) on survival in patients with resectable gallbladder adenocarcinoma.
We retrospectively analyzed the National Cancer Database from 2004 to 2020. We included patients with gallbladder adenocarcinoma who had undergone resection of the primary site as well as adequate lymphadenectomy. Exclusions comprised patients with distant metastasis and missing key data. LNR was calculated as a proportion of positive lymph nodes (LNs) to examined LNs.
Patients were stratified into LNR groups: LNR0 - 343 patients (55%); 168 (26.9%) patients with LNR < 30%; and 113 (18.1%) with LNR ≥ 30%. The mean age was 67.3 ± 10.7 years, with 71.6% being female and 75.8% identifying as white. The mean overall survival (OS) was 52.8 months for the LNR0 group, 36.3 months for LNR < 30%, and 27 months for LNR ≥ 30% (p < 0.001). The difference in survival was significant when adjusted for adjuvant chemotherapy status and surgical margins using Cox regression - HR 3.2 (2.4-4.5 95% CI) for LNR < 30% and HR 4.9 (3.5-6.8 95% CI) for LNR ≥ 30%.
The study suggests that LNR is a valuable prognostic factor for resectable gallbladder cancer patients and could potentially guide treatment decisions.
本研究旨在探讨淋巴结比率（LNR）对可切除胆囊腺癌患者生存的影响。
我们回顾性分析了 2004 年至 2020 年国家癌症数据库。纳入接受原发病灶切除术和充分淋巴结清扫术的胆囊腺癌患者。排除远处转移和关键数据缺失的患者。LNR 计算为阳性淋巴结（LNs）与检查 LNs 的比例。
患者被分为 LNR 组：LNR0-343 例（55%）；LNR<30%的患者有 168 例（26.9%）；LNR≥30%的患者有 113 例（18.1%）。平均年龄为 67.3±10.7 岁，女性占 71.6%，白人占 75.8%。LNR0 组的总生存期（OS）为 52.8 个月，LNR<30%组为 36.3 个月，LNR≥30%组为 27 个月（p<0.001）。使用 Cox 回归调整辅助化疗状态和手术切缘后，生存差异具有统计学意义——LNR<30%的 HR 为 3.2（2.4-4.5 95%CI），LNR≥30%的 HR 为 4.9（3.5-6.8 95%CI）。
本研究表明 LNR 是可切除胆囊癌患者有价值的预后因素，可能有助于指导治疗决策。
