pT2期胆囊癌的手术治疗及预后

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。

Surgical treatment and prognosis of gallbladder carcinoma of pT2 stage

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.