Analysis of impact factors on prognosis of patients with gallbladder adenocarcinoma after surgery / 中华肝胆外科杂志

ABSTRACT

Objective To study the impact factors on prognosis of patients with gallbladder adenocarcinoma after surgery.Methods The clinicopathological data of 1 285 patients who underwent surgery and were histologically confirmed to have gallbladder adenocarcinoma from 2004 to 2014 was extracted from the SEER database of US National Cancer Institute.Life table was used to calculate the survival rate.Kaplan-Meier was used to construct the survival curves.Univariate and Cox multivariate regression analysis were applied to evaluate the prognostic factors.The univariate analysis was evaluated by the log-rank x2 test.Results The median survival of 1 285 patients with gallbladder adenocarcinoma was 32 months.The 1-,3-and 5-year survival rates were 77.5％,46.8％ and 36.5％,respectively.The 5-year survival rates of stage Ⅰ,Ⅱ,ⅢA,ⅢB,ⅣA,ⅣB were 72.7％,63.2％,24.6％,20.5％,0 and 5.1％,respectively.The median survival of stage ⅢA,ⅢB,ⅣA and ⅣB were 22 months,19 months,12 months and 16 months,respectively.The differences were statistically significant (P ＜ O.05).Univariate analysis showed that sex,age,degree of differentiation,tumor size,T staging,N staging,number of lymph nodes detected,lymph node metastasis rate,location of lymph node metastasis,and American Joint Commission on cancer (AJCC) staging were significantly associated with prognosis (P ＜ 0.05).There was no significant differences among race and marital status with prognosis (P ＞ 0.05).Multivariate Cox regression analysis showed that sex (male),age (≥ 65 years),degree of differentiation,T staging,number of lymph nodes detected (＜ 4)and AJCC staging were independent risk factors affecting prognosis of patients with gallbladder adenocarcinoma (P ＜ 0.05).Conclusions With increase in AJCC staging,the survival rates in patients with gallbladder adenocarcinoma after surgery decreased gradually.Parameters including sex,age,T staging,number of lymph nodes detected and AJCC staging were independent factors affecting prognosis of patients with gallbladder adenocarcinoma after surgery.