Recent trends of gallbladder cancer in Japan - An analysis of 4770 patients
Recent trends of gallbladder cancer in Japan - An analysis of 4770 patients
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DOI：
10.1002/cncr.22815
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发表时间：
2007-08-01
期刊：
影响因子：
6.2
通讯作者：
Nagakawa, Takukazu
中科院分区：
文献类型：
--
作者：
Kayahara, Masato;Nagakawa, Takukazu
背景胆囊癌是最常见的胆道癌症，在智利、日本和北方印度发病率特别高。许多日本外科医生报告说，积极的手术改善了胆囊癌患者的预后。日本和其他国家的存活率存在差异。本研究的目的是确定是否有任何变化，随着时间的推移，在发病率，治疗方法，诊断阶段，或预后的胆囊癌在一个完整的，以社区为基础的系列患者在日本。根据日本胆道外科学会胆道癌登记委员会的数据，分析了1988年至1997年间4774例胆囊癌患者。生存率与手术分期密切相关，I期患者的5年生存率为77%，11期患者为60%，III期患者为29%，IVA期患者为12%，IVB期患者为3%。患者年龄也影响生存率。年龄< 49岁患者的生存率明显优于其他组患者的生存率（P <79岁患者的生存率明显低于其他4组患者的生存率（P <79岁患者的生存率为21%）。根据日本胆道外科学会分类，按分期对患者进行分层，结果显示，在I期和II期疾病患者中，女性的生存率高于男性。辅助化疗没有提供生存益处。1988 ~ 1992年和1993 ~ 1997年的患者人口统计学资料无明显变化。在这项研究中，作者评估了日本胆囊癌的趋势。日本胆道外科学会提出的胆道癌分类反映了胆囊癌患者的预后。患者结局受患者年龄和性别的影响。在10年的研究期间，患者生存率没有明显的实质性差异。数据不支持积极手术切除和辅助化疗的任何优势。进一步分析手术过程将是必要的，以最终确定是否有任何生存优势，从积极的手术治疗晚期胆囊癌患者。
Background. Gallbladder cancer is the most common cancer of the biliary tract and has a particularly high incidence in Chile, Japan, and northern India. Many Japanese surgeons have reported that aggressive surgery improves the outcome of patients with gallbladder cancer. Differences in survival rates between Japan and other countries have been noted. The objective of this study was to determine whether there were any changes over time in the incidence, therapeutic approach, stage at diagnosis, or prognosis of gallbladder cancer in an unselected, community-based series of patients in Japan.Methods. in total, 4774 patients with gallbladder cancer were analyzed between 1988 and 1997 based on data from the Biliary Tract Cancer Registration Committee of the Japanese Society of Biliary Surgery.Results. Survival was related closely to surgical stage, with 5-year survival rates of 77% for patients with stage I disease, 60% for patients with stage 11 disease, 29% for patients with stage III disease, 12% for patients with stage IVA disease, and 3% for patients with stage IVB disease. Patient age also affected survival. The survival rate for patients aged < 49 years was significantly better compared with the survival rate for patients in the other groups (P 79 years was significantly worse compared with the survival rate for patients in the other 4 groups (P 79 years was 21%. Stratifying patients by stage according to the Japanese Society of Biliary Surgery classification showed that women maintained a survival advantage over men among patients with stage I and II disease. Adjuvant chemotherapy did not provide a survival benefit. There were no apparent changes in patient demographics between the period from 1988 to 1992 and the period from 1993 to 1997.Conclusions. For this study, the authors evaluated the gallbladder cancer trends in Japan. The Classification of Biliary Tract Carcinoma proposed by the Japanese Society of Biliary Surgery reflected the prognosis of patients with gallbladder cancer. Patient outcomes were affected by patient age and sex. No substantial differences in patient survival were apparent over the 10-year study period. The data did not support any advantage for aggressive surgical resection and adjuvant chemotherapy. Further analysis of operative procedures will be necessary to determine conclusively whether there is any survival advantage from aggressive surgery in patients with advanced gallbladder cancer.