Outcomes and prognostic factors in gallbladder cancer: a single-centre experience
Outcomes and prognostic factors in gallbladder cancer: a single-centre experience
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DOI：
10.1007/s00423-012-0950-8
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发表时间：
2012-08-01
影响因子：
2.3
通讯作者：
Stier, Albrecht
中科院分区：
文献类型：
--
作者：
Cziupka, Katharina;Partecke, Lars Ivo;Stier, Albrecht
胆囊癌是胆道系统最常见的恶性肿瘤，预后极差。在这项研究中，我们回顾评估了42例经组织学证实的胆囊癌患者，用Kaplan-Meier方法计算估计的生存率，用logrank检验评估差异。GKR(癌症联合登记)和人口统计数据被用来获得社区癌症统计数据的信息。在这项研究中，转移患者的存活率较低。此外，R0切除、肿瘤体积较小和无淋巴转移的患者的存活率明显较好。T分期、M分期和R分期是独立的预后参数。性别和年龄对存活率无显著影响。此外，我们还发现，偶发胆囊癌和胆囊结石患者的存活率显著高于其他患者。研究小组的人口统计分析证实，我们机构在我们的集水区的事件病例覆盖率很高，与胆囊癌的预期发病率没有明显的地区差异。尽管不同地理区域的发病率存在差异，但胆囊癌在德国东北部以农村为主的西波美拉尼亚似乎是相当正常的分布。在我们的集水区，事件的覆盖率很高。T期、M期和R期是本研究中独立的预后因素。我们的结论是，只要有可能，R0切除应该是所有术前可切除的患者的手术目标，但对于高度晚期癌症或严重伴发非肿瘤性疾病的患者，英雄式切除是不必要的。
Gallbladder cancer is the most common malignant tumour of the biliary system with an extraordinarily poor prognosis. In this study, we retrospectively evaluated forty-two patients with histologically proven gallbladder cancer.Estimated survival rates were calculated by the Kaplan-Meier method, and differences were assessed using the logrank test. The GKR (combined registry of cancer) and demographic data were used to gain information on community cancer statistics.In this study, patients with metastases showed poorer survival rates. Furthermore, the survival was significantly better in patients with R0 resections, smaller tumour sizes and without lymph node infiltration. T stage, M stage and R stage were independent prognostic parameters. Sex and age had no significant effect on survival. Also, we found that patients with incidental gallbladder cancer and those with cholecystolithiasis showed significantly better survival rates. Demographic analyses of the study group confirmed a high coverage of our institution for incident cases in our catchment area and no significant regional deviations from the expected incidence of gallbladder cancer.Despite differences in the incidence in different geographical areas, gallbladder cancer appears to be fairly normally distributed in Western Pomerania, a predominantly rural area of Northeastern Germany. Coverage of incident cases in our catchment area was high. T stage, M stage and R stage were independent prognostic factors in our study. We conclude that, whenever possible, an R0 resection should be the surgical goal in all patients staged resectable before surgery, but heroic resections in patients with highly advanced cancer disease or severe accompanying non-tumour diseases are not warranted.