摘要
目的探讨意外胆囊癌的临床处理对策与预后。方法回顾性分析意外胆囊癌51例,对其治疗与预后进行统计分析。生存分析采用Kaplan-Meier法,组间比较采用Log-rank检验,多因素分析采用Cox比例风险模型。结果多因素分析表明肿瘤位置、Nevin分期及手术方式是影响预后的独立因素;对于Ⅱ期体底部胆囊癌和Ⅲ、Ⅳ期体底部胆囊癌以及颈部胆囊癌,胆囊癌根治术组优于单纯胆囊切除术组,其差异有统计学意义(P值分别为0.014、0.001及0.018);对于Ⅰ期体底部胆囊癌,单纯胆囊切除术组与胆囊癌根治术组病人的生存率差异无统计学意义(P=0.312)。结论对于NevinⅠ期体底部胆囊癌病人,单纯胆囊切除术已达到根治效果;对于NevinⅠ期颈部胆囊癌及NevinⅡ期以晚的胆囊癌,胆囊癌根治术能有效改善其预后。
Objective To explore the prognostic factors associated with surgical procedures, tumor stages and locations in the patients with unexpected gallbladder carcinoma （UGC）. Methods The retrospective statistic analysis of 51 patients with UGCs was performed. Kaplan-Meier estimate was employed for the survival analysis, Log-rank test for the group comparisons and Cox proportional hazard model for multivariate analysis. Results Multivariate analysis showed that the locations and Nevin stages of tumors and surgical methods were independent factors of prognosis for the UGC patients. The survival terms were of statistic significance between the radical cholecystectomy groups and simple cholecystectomy groups for the patients with stage Ⅱ , Ⅲ, Ⅳ carcinomas located in the fundus and body of the gallbladder and for the patients with carcinomas located in the neck of the gallbladder. There was no significant deference in the survival terms of patients with stage Ⅰ carcinomas in the fundus and body of the gallbladder regardless of performance of radical cholecystectomy or simple cholecystectomy. Conclusions For stage Ⅰ UGC patients with tumors located in the fundus and the body of the gallbladder, simple cholecystectomy is a good surgical procedure. For the UGC patients at more advanced stages or with the tumors located at the neck of the gallbladder, radical cholecystectomy was crucial to enhance the survival rate.
出处
《中华肝胆外科杂志》
CAS
CSCD
2007年第11期744-746,共3页
Chinese Journal of Hepatobiliary Surgery
关键词
胆囊肿瘤
胆囊切除术
胆囊癌根治术
Gallbladder neoplasms
Cholecystectomy
Radical cholecystectomy
