Cholecystectomy is associated with higher risk of early recurrence and poorer survival after curative resection for early stage hepatocellular carcinoma.
Cholecystectomy is associated with higher risk of early recurrence and poorer survival after curative resection for early stage hepatocellular carcinoma.
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胆囊切除术与早期肝细胞癌根治性切除后早期复发风险较高和生存率较差相关
DOI：
10.1038/srep28229
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发表时间：
2016-06-20
影响因子：
4.6
通讯作者：
Fan J
中科院分区：
文献类型：
--
作者：
Li T;Wang SK;Zhi XT;Zhou J;Dong ZR;Zhang ZL;Sun HC;Ye QH;Fan J
虽然胆囊切除术与肝细胞癌（HCC）发生风险增加有关，但胆囊切除术与接受根治性切除术的HCC患者预后之间的关系从未被研究过。通过回顾性分析3933例肝癌根治性切除患者的资料，发现胆囊切除术是影响早期肝癌患者无复发生存率的独立预后因素（BCLC 0/A阶段）（p = 0.020，HR：1.29，95% CI：胆囊切除术组早期1、3、5年RFS率明显低于非胆囊切除术组（80.5%、61.8%、52.0% vs 88.2%、68.8%、56.8%，p = 0.033）。胆囊切除术组早期复发率显著高于非胆囊切除术组（59/47 vs 236/333，p = 0.007），但晚期（BCLC C期）患者的复发率无显著差异（p = 0.194）。多因素分析显示胆囊切除术是早期肝癌早期复发的独立危险因素（p = 0.005，HR：1.52，95%CI：1.13-2.03），但不是晚期复发的独立危险因素（p = 0.959）。总之，胆囊切除术是早期复发的一个独立预测因素，并且与早期肝癌的RFS较差相关。早期肝癌切除术中可避免切除正常胆囊。
Although cholecystectomy has been reported to be associated with increased risk of developing hepatocellular carcinoma (HCC), the association between cholecystectomy and prognosis of HCC patients underwent curative resection has never been examined. Through retrospective analysis of the data of 3933 patients underwent curative resection for HCC, we found that cholecystectomy was an independent prognostic factor for recurrence-free survival (RFS) of patients at early stage (BCLC stage 0/A) (p = 0.020, HR: 1.29, 95% CI: 1.04–1.59), and the 1-, 3-, 5-year RFS rates for patients at early stage were significantly worse in cholecystectomy group than in non-cholecystectomy group (80.5%, 61.8%, 52.0% vs 88.2%, 68.8%, 56.8%, p = 0.033). The early recurrence rate of cholecystectomy group was significantly higher than that of non-cholecystectomy group for patients at early stage (59/47 vs 236/333, p = 0.007), but not for patients at advanced stage (BCLC stage C) (p = 0.194). Multivariate analyses showed that cholecystectomy was an independent risk factor for early recurrence (p = 0.005, HR: 1.52, 95% CI: 1.13–2.03) of early stage HCC, but not for late recurrence (p = 0.959). In conclusion, cholecystectomy is an independent predictor for early recurrence and is associated with poorer RFS of early stage HCC. Removal of normal gallbladder during HCC resection may be avoided for early stage patients.