基于SEER数据库分析联合肝切除术对Ⅱ期胆囊癌患者预后的影响  

Prognostic impact of surgical treatment combined with hepatectomy on stage Ⅱ gallbladder cancer:a SEER-based study

作　　者：胡炳仁[1] 叶陈涛 屠卓隆 蔡华杰[1] 杨寿璋 杨盈楠 屠金夫[1] HU Bing-ren;YE Chen-tao;TU Zhuo-long;CAI Hua-jie;YANG Shou-zhang;YANG Ying-nan;TU Jin-fu(Department of Hepato-Pancreato-Biliary Surgery,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325000,China)

机构地区：[1]温州医科大学附属第一医院肝胆胰外科,浙江温州325035

出　　处：《肝胆胰外科杂志》2021年第6期331-335,共5页Journal of Hepatopancreatobiliary Surgery

基　　金：浙江省医药卫生科技计划项目(2021RC089);温州市基础性科研项目(Y2020042)。

摘　　要：目的拟应用大数据库样本探讨不同手术策略对Ⅱ期胆囊癌患者预后影响是否有差异。方法从美国SEER数据库筛选2004年1月1日至2015年12月31日间诊断的529例Ⅱ期胆囊癌患者,按手术策略分为联合肝脏切除术组、非联合肝脏切除术组,通过Kaplan-Meier生存分析绘制生存曲线并计算中位生存时间,利用Cox风险回归模型研究Ⅱ期胆囊癌患者预后的独立风险因素。结果接受联合肝脏切除术的患者生存结局[中位生存时间(median survival time,MST)=113个月]长于接受非联合肝脏切除术的患者(MST=79个月),但两者无统计学差异(P=0.165)。Cox回归模型提示年龄是Ⅱ期胆囊癌患者预后的独立风险因素,手术策略对生存结局影响无统计学差异(HR 0.733,95%CI 0.471~1.141,P=0.169)。结论接受联合肝脏切除术的Ⅱ期胆囊癌患者预后与接受非联合肝脏切除术的患者预后无明显差异,联合肝切除或许不是Ⅱ期胆囊癌患者的必要治疗手段。Objective To discuss the prognostic impact of different surgical treatments on stage Ⅱ gallbladder cancer(GBC) patients. Methods Patients diagnosed with stage Ⅱ GBC between Jan. 1 2004 and Dec. 31 2015 were selected from the Surveillance, Epidemiology, and End Results(SEER) database and were divided into surgery combined with hepatectomy group and surgery without hepatectomy group. Survival curves and median survival time(MST) were analyzed by Kaplan-Meier method. Cox regression model was used to determine the risk factors. Results Patients with stage Ⅱ GBC undergoing surgery combined with hepatectomy had a longer MST(113 months) than those without hepatectomy(79 months), but the difference was not statistical significant(P=0.165). In the COX regression model, age was an independent prognositic factor, but surgery was not a significant independent factor for overall survival(HR 0.733, 95%CI 0.471~1.141, P=0.169). Conclusion Survival outcomes for patients with stage Ⅱ GBC underwent surgery with hepatectomy are not significantly different from those without hepatectomy. Hepatectomy may not be essential for stage Ⅱ GBC surgical treatment.

关 键 词：Ⅱ期胆囊癌 胆囊癌外科治疗 肝切除术 SEER数据库 生存分析 

分 类 号：R735.8[医药卫生—肿瘤]