胆囊腺鳞状癌：处理这种罕见实体的双机构经验。

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2025-02-17 DOI:10.1016/j.hpb.2025.02.004

Gurudutt P Varty, Shraddha Patkar, Sujat Lele, Swapnil Patel, Gauri Deshpande, Ipsita Dhal, Mufaddal Kazi, Akash Pawar, Vikas Ostwal, Anant Ramaswamy, Prabhat Bhargava, Mahesh Goel

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引用次数: 0

摘要

背景：腺鳞胆囊癌是一种罕见的胆囊癌。有关ASGBC管理的数据相对缺乏。方法：根据预先定义的“TMH标准”，将2012年1月至2022年3月诊断为ASGBC的患者分为“早期”、“局部晚期”和“转移性”ASGBC。结果：196例患者被分为早期ASGBC （n = 19,9.7%）、LA - ASGBC （n = 53,27%）和M - ASGBC (n = 124,63.3%)，中位总生存期（OS） M - ASGBC最差（3.9个月），早期ASGBC最好（未达到）。手术治疗的LA-ASGBC患者的1年和3年OS明显高于非手术治疗的患者（72.6%,35.6% vs 25.1%, 0%, p）。结论：边缘阴性手术切除加围手术期化疗的多模式治疗是ASGBC患者长期生存的最佳选择。

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Adenosquamous carcinoma of the gallbladder: a Bi-institutional experience in managing this rare entity.

Background: Adenosquamous Gallbladder Cancers (ASGBC) are rare variety of GBCs. Relative paucity of data with regards to the management of ASGBC exists.

Methods: Patients with diagnosis of ASGBC from January 2012 to March 2022 were categorised into 'Early', 'Locally advanced (LA)' and 'Metastatic (M)' ASGBC as per the predefined 'TMH Criteria'.

Results: A total of 196 patients included were categorised into early ASGBC (n = 19,9.7%), LA - ASGBC (n = 53,27%) and M - ASGBC (n = 124,63.3%) with median overall survival (OS) being worst for M - ASGBC (3.9 months) and best for early ASGBC (not reached). The 1-year and 3-year OS of LA-ASGBC patients who underwent surgery was significantly higher than those with non-surgical treatment (72.6%, 35.6% vs 25.1%, 0%, p <0.001). Although, the median OS of resected ASGBC was less as compared to resected gallbladder adenocarcinomas (GBACs) (40.8 vs. 56.1 months), it did not reach statistical significance (p=0.06). However, at higher stages of resected LA - ASGBC (Stage III), the median OS was significantly lower as compared to stage-matched resected GBACs (14.5 vs. 30.1 months, p= 0.006).

Conclusion: Multimodality treatment consisting of margin negative surgical resection with perioperative chemotherapy offers the best chance of long-term survival in ASGBC.

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来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).