Kim Minha, Vengatesan Keerthivasan, Aploks Krist, Thompson Kyle, Dong Xiang, Seshadri Ramanathan
Department of General Surgery, Danbury Hospital, Danbury, CT 06810, United States.
Department of Clinical Research, Danbury Hospital, Danbury, CT 06810, United States.
World J Gastrointest Surg. 2025 May 27;17(5):103653. doi: 10.4240/wjgs.v17.i5.103653.
For locally advanced gallbladder cancer, previous clinical studies have demonstrated that chemotherapy results in significant survival benefits when compared to surgery alone. However, data demonstrating a similar survival benefit with early-stage gallbladder cancer is limited. This study seeks to evaluate the impact chemotherapy has on survival in patients with early-stage gallbladder cancer using a large, multi-institution database.
To investigate the survival benefit of chemotherapy in patients with stage II gallbladder cancer.
We performed a retrospective multivariable analysis of the National Cancer Database from 2010 to 2017 to evaluate the effect that chemotherapy has on the survival of patients with stage II gallbladder cancer. Our objective was to determine if there were any statistically significant survival differences between those who received surgery and chemotherapy those who only underwent surgery.
Of the 899 patients with stage II gallbladder cancer, 328 patients had undergone chemotherapy and surgery. The average overall survival for those who had surgery and chemotherapy only surgery was 52.6 months and 51.1 months, respectively. This difference was not statistically significant ( = 0.2). In the secondary analysis, the surgical group who had a liver resection had better overall survival ( < 0.0001).
Practitioners should carefully consider chemotherapy for early-stage gallbladder cancer, as risks may outweigh survival benefits, and surgeons should also consider liver resections as part of their surgical management.
对于局部晚期胆囊癌，既往临床研究表明，与单纯手术相比，化疗可带来显著的生存获益。然而，关于早期胆囊癌化疗有类似生存获益的数据有限。本研究旨在利用一个大型多机构数据库评估化疗对早期胆囊癌患者生存的影响。
探讨化疗对II期胆囊癌患者的生存获益。
我们对2010年至2017年国家癌症数据库进行了回顾性多变量分析，以评估化疗对II期胆囊癌患者生存的影响。我们的目的是确定接受手术加化疗的患者与仅接受手术的患者之间是否存在任何具有统计学意义的生存差异。
在899例II期胆囊癌患者中，328例患者接受了化疗和手术。接受手术加化疗的患者与仅接受手术的患者的平均总生存期分别为52.6个月和51.1个月。这种差异无统计学意义（P = 0.2）。在二次分析中，接受肝切除术的手术组总生存期更好（P < 0.0001）。
从业者应谨慎考虑对早期胆囊癌进行化疗，因为风险可能超过生存获益，外科医生也应考虑将肝切除术作为其手术治疗的一部分。
