pT_2期胆囊癌的手术治疗及预后

Surgical treatment and prognosis of gallbladder carcinoma of pT_2 stage

目的:探讨pT2期胆囊癌的治疗与预后。方法:15例pT2期胆囊癌病例入选,对比分析存活率和手术相关的4个预后因素,包括手术方式、手术中是否有胆汁溢出,手术切缘是否残留肿瘤、淋巴结是否转移。结果:全组单纯胆囊切除术8例,胆囊癌根治术7例;胆汁溢出发生3例,手术切缘肿瘤残留3例,淋巴结转移5例。多因素分析表明手术切缘是否残留肿瘤、手术方式、胆汁溢出及淋巴结是否转移是影响预后的独立因素;Log-rank检验表明生存率与手术切缘是否阴性、手术方式、胆汁溢出及淋巴结是否转移有相关性。结论:对于pT2期胆囊癌患者,如果患者无淋巴结转移,术中无胆汁溢出,手术切缘肿瘤无残留,行根治性胆囊癌手术可达到较好效果。

Objective： To investigate the surgical treatment and prognosis of gallbladder carcinoma of pT2 stage.Methods： Fifteen patients with gallbladder carcinoma of pT2 stage were selected.The correlation was evaluated between cumulative survival rates and the following 4 prognostic factors correlate operation：type of operation,bile spillage,tumor residual size and lymph node metastasis.Results： There were eight patients accepted cholecystectomy,and 7 Radical resection.Bile spillage was found in 3 patients.Three patients were discovered to have tumor residues in surgical margin.Five patients were discovered to have lymph node metastasis.Multiple-factor analysis indicated that tumor residual size,surgical procedures,bile spillage and lymph nodes metastasis are independent prognostic factor.Log-rank test showed that the survival rates was statistically correlated R0 tumor residue,surgical procedures,bile spillage and lymph nodes metastasis.Conclusion： As for gallbladder carcinoma of pT2 stage,If patients without lymph node metastasis,bile spillage and tumor residual,gallbladder cancer with radical surgery can achieve better results than cholecystectomy.