AJCC第八版Ⅲ期不同亚组分型的胆囊癌临床特征及预后分析—基于SEER数据库的研究

目的 研究美国癌症联合委员会（AJCC）第8版Ⅲ期胆囊癌（GBC）亚组分型的临床特征、治疗方式及预后。方法 收集3 485名AJCC第8版Ⅲ期胆囊癌患者的临床资料、随访结果并进行对比。绘制并比较ⅢA和ⅢB，T3N0M0（ⅢA）、T1~2N1M0（ⅢB）和T3N1M0（ⅢB）的Kaplan-Meier生存曲线。单因素和Cox多因素回归分析临床特征、治疗方案、Ⅲ期亚组分型与预后间的关系。结果 ⅢB期胆囊癌患者1年生存率（49.70%）高于ⅢA期（36.41%）；T1~2N1M0（ⅢB）期胆囊癌患者1年生存率（65.52%）高于T3N0M0（ⅢA）期（36.41%）和T3N1M0（ⅢB）期（37.05%）。Cox多因素分析，年龄、肿瘤分级、肿瘤大小、手术方式、放疗、化疗、AJCC第8版TNM具体亚组分型和T分期是影响Ⅲ期GBC预后的独立相关因素（P<0.01）。结论 ⅢB期GBC总体生存预后优于ⅢA期；Ⅲ期GBC死亡风险：T1~2N1M0（ⅢB）

Clinical Characteristics and Prognosis of AJCC 8th Edition Stage Ⅲ Gallbladder Cancer with Different Subtypes: A Study Based on SEER Database

Objective To investigate the clinical characteristics, treatment and prognosis of the eighth edition of AJCC stage Ⅲ gallbladder cancer (GBC). Methods We collected the clinical data and follow-up results of 3485 patients with AJCC 8th stage Ⅲ gallbladder cancer. Kaplan Meier survival curves of ⅢA and ⅢB, T3N0M0 (ⅢA), T1-2N1M0 (ⅢB) and T3N1M0 (ⅢB) were drawn and compared. Single factor analysis and Cox multiple factor regression analysis were used to analyze the relation between clinical characteristics, treatment plan, stage Ⅲ subtype and prognosis. Results One-year survival rate of stage ⅢB gallbladder cancer patients was 49.70%, higher than those of stage ⅢA(36.41%); the 1-year survival rate of stage T1-2N1M0 (ⅢB) gallbladder cancer patients was 65.52%, higher than those of stage T3N0M0 (ⅢA) (36.41%) and stage T3N1M0 (ⅢB) (37.05%). According to Cox multivariate analysis, age, tumor grade, tumor size, operation mode, radiotherapy, chemotherapy, AJCC 8th TNM specific subtype and T stage were independent related factors affecting the prognosis of stage Ⅲ GBC patients (P<0.01). Conclusion The overall survival of stage ⅢB GBC is better than that of stage ⅢA. The risk of stage Ⅲ GBC death was T1-2N1M0 (ⅢB)