T3胆囊癌：根据肿瘤扩散方式及肿瘤可切除性的治疗考虑手术结果

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2025-09-17 DOI:10.1016/j.ejso.2025.110457

Yusuke Kawachi , Jun Sakata , Tatsuya Nomura , Kabuto Takano , Takuya Ando , Koji Toge , Yuki Hirose , Kazuyasu Takizawa , Hirosuke Ishikawa , Shun Abe , Hiroshi Ichikawa , Yoshifumi Shimada , Takashi Kobayashi , Toshifumi Wakai

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引用次数: 0

摘要

本研究旨在明确pT3胆囊癌患者根据肿瘤扩散方式的手术结局。方法对85例pT3期胆囊癌患者行根治性手术的临床资料进行分析。根据肿瘤的扩散方式进行分类。结果：单纯累及肝脏（n = 25）、单纯累及肝外胆管（n = 29）、单纯累及其他脏器/结构或单纯浆膜腹膜侧穿孔（n = 9）、同时累及肝脏和其他脏器/结构（n = 22）患者的5年总生存率（OS）分别为36.0%、29.0%、22.2%和9.1%。对于仅累及肝脏的患者，无论肝切除术类型如何，5年总生存率为30%。在29例仅累及肝外胆管的患者中，8例患者存活≥5年；3例行扩大胆囊切除术，5例行更广泛的胆囊切除术。尽管进行了广泛的切除，但同时累及肝脏和其他器官/结构的患者的5年总生存率为12.5%。不累及肝脏或肝外胆管的扩散方式是不良OS的独立预测因子（风险比1.675;p = 0.046）。结论对于单纯累及肝脏或肝外胆管的pT3型胆囊癌，不论采用何种切除方式，手术均是可接受的选择。然而，对于其他扩散方式的肿瘤，手术的生存效益有限。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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T3 gallbladder cancer: surgical outcomes according to the mode of tumor spread and treatment considerations for oncological resectability

Background

This study aimed to clarify surgical outcomes for patients with pT3 gallbladder cancer according to the mode of tumor spread.

Methods

A total of 85 patients with pT3 gallbladder cancer who underwent curative-intent surgery were analyzed. Each tumor was classified according to the mode of spread.

Results

Five-year overall survival (OS) in patients with involvement of the liver alone (n = 25), involvement of the extrahepatic bile duct alone (n = 29), involvement of one other organ/structure alone or perforation of the peritoneal side of the serosa alone (n = 9), and involvement of both the liver and one other organ/structure (n = 22) was 36.0%, 29.0%, 22.2%, and 9.1%, respectively. For patients with involvement of the liver alone, 5-year OS was > 30% regardless of type of hepatectomy. Among 29 patients with involvement of the extrahepatic bile duct alone, 8 patients survived ≥ 5 years; 3 underwent extended cholecystectomy and 5 underwent more extensive resection. Despite performing extensive resection, 5-year OS was 12.5% for patients with involvement of both the liver and one other organ/structure. The mode of spread other than involvement of the liver alone or extrahepatic bile duct alone was an independent predictor of worse OS (hazard ratio 1.675; p = 0.046).

Conclusions

Surgery is an acceptable option for pT3 gallbladder cancer with involvement of the liver alone or extrahepatic bile duct alone regardless of the type of resection procedure. However, the survival benefit of surgery is limited for this tumor with other modes of spread.

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来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.