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AJCC第八版Ⅲ期不同亚组分型的胆囊癌临床特征及预后分析—基于SEER数据库的研究

Clinical Characteristics and Prognosis of AJCC 8th Edition Stage Ⅲ Gallbladder Cancer with Different Subtypes: A Study Based on SEER Database

  • 摘要:
    目的 研究美国癌症联合委员会(AJCC)第8版Ⅲ期胆囊癌(GBC)亚组分型的临床特征、治疗方式及预后。
    方法 收集3 485名AJCC第8版Ⅲ期胆囊癌患者的临床资料、随访结果并进行对比。绘制并比较ⅢA和ⅢB,T3N0M0(ⅢA)、T1~2N1M0(ⅢB)和T3N1M0(ⅢB)的Kaplan-Meier生存曲线。单因素和Cox多因素回归分析临床特征、治疗方案、Ⅲ期亚组分型与预后间的关系。
    结果 ⅢB期胆囊癌患者1年生存率(49.70%)高于ⅢA期(36.41%);T1~2N1M0(ⅢB)期胆囊癌患者1年生存率(65.52%)高于T3N0M0(ⅢA)期(36.41%)和T3N1M0(ⅢB)期(37.05%)。Cox多因素分析,年龄、肿瘤分级、肿瘤大小、手术方式、放疗、化疗、AJCC第8版TNM具体亚组分型和T分期是影响Ⅲ期GBC预后的独立相关因素(P < 0.01)。
    结论 ⅢB期GBC总体生存预后优于ⅢA期;Ⅲ期GBC死亡风险:T1~2N1M0(ⅢB) < T3N0M0(ⅢA) < T3N1M0(ⅢB);实施胆囊癌根治术(淋巴结清扫≥6枚)、放疗、化疗有利于Ⅲ期GBC预后的改善。

     

    Abstract:
    Objective To investigate the clinical characteristics, treatment and prognosis of the eighth edition of AJCC stage Ⅲ gallbladder cancer (GBC).
    Methods We collected the clinical data and follow-up results of 3485 patients with AJCC 8th stage Ⅲ gallbladder cancer. Kaplan Meier survival curves of ⅢA and ⅢB, T3N0M0 (ⅢA), T1-2N1M0 (ⅢB) and T3N1M0 (ⅢB) were drawn and compared. Single factor analysis and Cox multiple factor regression analysis were used to analyze the relation between clinical characteristics, treatment plan, stage Ⅲ subtype and prognosis.
    Results One-year survival rate of stage ⅢB gallbladder cancer patients was 49.70%, higher than those of stage ⅢA(36.41%); the 1-year survival rate of stage T1-2N1M0 (ⅢB) gallbladder cancer patients was 65.52%, higher than those of stage T3N0M0 (ⅢA) (36.41%) and stage T3N1M0 (ⅢB) (37.05%). According to Cox multivariate analysis, age, tumor grade, tumor size, operation mode, radiotherapy, chemotherapy, AJCC 8th TNM specific subtype and T stage were independent related factors affecting the prognosis of stage Ⅲ GBC patients (P < 0.01).
    Conclusion The overall survival of stage ⅢB GBC is better than that of stage ⅢA. The risk of stage Ⅲ GBC death was T1-2N1M0 (ⅢB) < T3N0M0 (ⅢA) < T3N1M0 (ⅢB). Radical cholecystectomy (number of dissected lymph node≥6), radiotherapy and chemotherapy are beneficial to the improvement of prognosis of stage Ⅲ GBC patients.

     

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