基于SEER数据库分析不同治疗方案对Ⅳ期胆囊癌患者预后的影响  

Prognosis of stage Ⅳ gallbladder cancer patients with different management options: a SEER-based study

作　　者：郑大雯 翟天宇[1] 张晓宇 庄鹏远[1] 沈军[1] 全志伟[1] 王健东[1] Zheng Dawen;Zhai Tianyu;Zhang Xiaoyu;Zhuang Pengyuan;Shen jun;Quan Zhiwei;Wang Jiandong(Department of General Surgery,XinHua Hospital Afiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of Cardiothoracic Surgery,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海交通大学医学院附属新华医院普外科,上海200092 [2]上海中医药大学附属岳阳中西医结合医院心胸外科,上海200437

出　　处：《中华转移性肿瘤杂志》2024年第4期344-349,共6页Chinese Journal of Metastatic Cancer

摘　　要：目的探究不同治疗方案对Ⅳ期胆囊癌预后的影响。方法从SEER数据库中筛选2010—2020年1811例确诊为Ⅳ期胆囊癌的患者,根据是否进行手术、手术方式和是否化疗分为6个组:A组,未治疗;B组,仅行化疗;C组,仅行胆囊切除术;D组,行胆囊切除术联合化疗;E组,仅行胆囊癌根治术;F组,行胆囊癌根治术联合化疗。采用Cox回归模型分析Ⅳ期胆囊癌患者预后的独立风险因素,通过Kaplan-Meier法进行总体和亚组生存分析。结果诊断年份、年龄、T分期、远处转移情况、治疗方案均为Ⅳ期胆囊癌独立的预后危险因素。手术联合化疗方案显著改善Ⅳ期胆囊癌患者预后,且无论是否联合化疗对胆囊切除术与胆囊癌根治术的中位生存时间无影响。结论手术联合化疗能延长Ⅳ期患者的生存时间,手术方式可以选择单纯胆囊切除术。化疗是局部进展不可切除胆囊癌改善预后的关键。ObjectiveTo evaluate the effects of different management options on the prognosis of stageⅣgallbladder cancer.MethodsTotal of 1811 patients diagnosed with stageⅣgallbladder cancer(2010-2020)were queried from the SEER database,and divided into 6 groups according to surgical procedures and chemotherapy:Group A:untreated patients;Group B:patients with chemotherapy;Group C:patients with cholecystectomy;Group D:patients with cholecystectomy combined with chemotherapy;Group E:patients with radical cholecystectomy;Group F:patients with radical cholecystectomy combined with chemotherapy.The Cox risk regression model was used to analyze the independent prognostic risk factors for patients with stageⅣgallbladder cancer,and survival analysis and subgroup analyses were performed by the Kaplan-Meier method.ResultsYear of diagnosis,age,T stage,distant metastasis,and treatment regimen were all independent prognostic risk factors for stageⅣgallbladder cancer.Surgery combined with chemotherapy significantly improved the prognosis of patients with stageⅣgallbladder cancer,and the difference in median survival time between cholecystectomy and radical cholecystectomy was not statistically significant,regardless of the combination of chemotherapy.ConclusionsSurgery combined with chemotherapy can prolong the survival of stageⅣpatients,and simple cholecystectomy could be a surgical option to some extent.Chemotherapy is the key to improving the prognosis of locally advanced unresectable gallbladder cancer.

关 键 词：Ⅳ期胆囊癌 外科学 辅助化疗 预后 SEER数据库分析 

分 类 号：R735.8[医药卫生—肿瘤]