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T1b-T3 期胆囊癌 R0 切除术后早期复发的预测
Authors Peng DZ , Nie GL, Li B, Cai YL, Lu J, Xiong XZ, Cheng NS
Received 6 October 2021
Accepted for publication 7 December 2021
Published 3 January 2022 Volume 2022:14 Pages 37—47
DOI https://doi.org/10.2147/CMAR.S342674
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Sanjeev Srivastava
Purpose: The time-to-tumor recurrence can predict the prognosis of hepatobiliary cancers following curative-intent resection. Therefore, for patients with gallbladder carcinoma (GBC) of stage T1b–T3 who had undergone R0 resection, we investigated the risk factors for early recurrence of GBC and their prognosis.
Patients and Methods: A total of 260 patients with GBC with T1b–T3 disease and an R0 margin were identified. Their clinicopathologic characteristics, perioperative details and prognostic data were reviewed. Survival analyses were carried out using the Kaplan–Meier method. Logistic regression models were used to identify the risk factors for early recurrence.
Results: The optimal cutoff for early recurrence was 29 months. Early recurrence tended to result in relapse far from the primary tumor, and such patients tended to have significantly worse overall survival. Multivariate analysis revealed that T3 disease, N1/N2 stage, poor differentiation of tumor, and lymphovascular invasion (LI) were associated with a greater risk of early recurrence. Patients diagnosed as having GBC incidentally and who had the risk factors of early recurrence were more likely to benefit from re-resection 2– 4 weeks after a cholecystectomy.
Conclusion: T3 stage, N1–N2 stage, poor differentiation, and LI were independent risk factors associated with early recurrence for patients with GBC with stage T1b–T3 disease after R0 resection.
Keywords: gallbladder carcinoma, early recurrence, prognosis, re-resection