The American surgeon · 2022
Survival Predictors of Resectable Gallbladder Carcinoma: An Analysis of the Surveillance, Epidemiology, and End Results Database.
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Zhu Jisheng, Wu Yunxiang, Xiao Weidong, Li Yong
Аннотация
BACKGROUND: To analyze population-level data for resectable gallbladder carcinoma (GBC) according to the eighth edition of the American Joint Committee on Cancer staging system.
METHODS: We queried the Surveillance, Epidemiology, and End Results database to identify all patients aged 18 years or older with T1-3 M0 GBC diagnosed between 2004 and 2015. Multivariate cox hazard regression analysis was used to identify prognostic factors of cancer-specific survival (CSS).
RESULTS: Of the 1601 eligible patients, 1310 (81.8%) underwent cholecystectomy only and 291 (18.2%) underwent an en bloc resection. Overall, 219 (13.7%) patients were in stage I, 400 (25%) were in stage II, 260 (16.2%) were in stage IIIA, 653 (40.8%) were in stage IIIB, and 69 (4.3%) were in stage IVB. The 5-year survival rates for patients were 82.7% for stage I, 73.4% for stage II, 31.9% for stage IIIA, 24.1% for stage IIIB, and 10% for stage IVB. Multivariate cox analysis indicated that predictors of decreased CSS included age at diagnosis >65 years, tumor size >3.2 cm, adenocarcinoma, increasing tumor spread, and lymph node involvement. Besides, chemotherapy and radiation were predictors of increased CSS.
CONCLUSIONS: Older age, increasing tumor size, adenocarcinoma, and advanced tumor/node stage were associated with a poorer prognosis after resection for GBC. Furthermore, patients with resectable GBC can benefit from adjuvant therapy.
METHODS: We queried the Surveillance, Epidemiology, and End Results database to identify all patients aged 18 years or older with T1-3 M0 GBC diagnosed between 2004 and 2015. Multivariate cox hazard regression analysis was used to identify prognostic factors of cancer-specific survival (CSS).
RESULTS: Of the 1601 eligible patients, 1310 (81.8%) underwent cholecystectomy only and 291 (18.2%) underwent an en bloc resection. Overall, 219 (13.7%) patients were in stage I, 400 (25%) were in stage II, 260 (16.2%) were in stage IIIA, 653 (40.8%) were in stage IIIB, and 69 (4.3%) were in stage IVB. The 5-year survival rates for patients were 82.7% for stage I, 73.4% for stage II, 31.9% for stage IIIA, 24.1% for stage IIIB, and 10% for stage IVB. Multivariate cox analysis indicated that predictors of decreased CSS included age at diagnosis >65 years, tumor size >3.2 cm, adenocarcinoma, increasing tumor spread, and lymph node involvement. Besides, chemotherapy and radiation were predictors of increased CSS.
CONCLUSIONS: Older age, increasing tumor size, adenocarcinoma, and advanced tumor/node stage were associated with a poorer prognosis after resection for GBC. Furthermore, patients with resectable GBC can benefit from adjuvant therapy.