The clinical impact of early recurrence and its recurrence patterns in patients with gallbladder carcinoma after radical resection

医学 阶段(地层学) 比例危险模型 单变量分析 逻辑回归 内科学 危险系数 胆囊 风险因素 辅助治疗 胃肠病学 肿瘤科 外科 多元分析 癌症 置信区间 古生物学 生物
作者
Q Li,Na Li,Qi Gao,Hengchao Liu,Xue Feng,Yali Cheng,Wenzhi Li,Chen Chen,Dong Zhang,Zhimin Geng
出处
期刊:Ejso [Elsevier BV]
卷期号:49 (10): 106959-106959 被引量:4
标识
DOI:10.1016/j.ejso.2023.06.011
摘要

It is common for patients with gallbladder carcinoma (GBC) to develop recurrence shortly after radical resection. We aimed to investigate the risk factors of early recurrence (ER) and its recurrence patterns and further analyze the effect of adjuvant chemotherapy (ACT) on ER and non-ER patients for decision-making in clinical practice.A total of 276 patients who underwent radical resection for GBC were retrospectively analyzed. Factors associated with overall survival (OS) and recurrence free survival (RFS) were identified using the Cox proportional hazard regression model, whereas ER was investigated using univariate and multivariable logistic regression models.The results indicated that 23.2% (64/276) of GBC patients developed ER after radical resection. ER was determined to be an independent risk factor for OS in patients with GBC after resection (P < 0.05). CA125, liver invasion, T stage, and N stage were independently associated with ER (P < 0.05). N1/N2 stage disease was an independent risk factor for OS, RFS and ER, and had a better predictive value in identifying ER than the other three variables associated with ER (P < 0.05). The liver and lymph nodes were the main first recurrence sites, and ER patients had a higher proportion of multisite recurrence. The prognosis of GBC patients with ER after radical resection differed significantly depending on whether ACT was provided, with ACT demonstrated to improve their prognosis (P < 0.05).Early recurrence after radical resection indicates a very poor prognosis in GBC and can be used to identify those who will benefit from ACT.
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