■胆囊癌(GBC)的预后令人沮丧。这项研究旨在比较辅助放化疗(ACR)与单纯手术(S)和辅助化疗(AC)的结果。
■监视,流行病学,和最终结果(SEER)计划数据库用于识别2004年至2015年间诊断为GBC并接受手术的患者。患者被分为S,AC,和ACR组根据他们的治疗。分类变量采用皮尔逊卡方检验进行比较,并进行1:1:1的倾向评分匹配分析(PSM)。用对数秩检验的Kaplan-Meier曲线评估总生存期。进行亚组分析。
■在SEER数据库中确定了总共5451名患者。PSM之后,接受S的患者的两年生存率,AC,ACR为36%,39%,45%,分别。ACR与两年生存率改善相关(p<0.001),而AC和S组的生存率相似(p=0.127),但ACR组优于AC组(p=0.012)。亚组分析表明,虽然II期GBC患者的两年生存率在组间没有显着差异(均p>0.05),在Ⅲa期,ACR与显著提高2年生存率相关(p=0.008)。Ⅲb(p<0.001),和Ⅳb(p<0.001)GBC患者。
■手术和ACR作为治疗方式的结合为GBC患者提供了更大的生存益处。特别是对于那些晚期肿瘤分期。
UNASSIGNED: The prognosis of gallbladder cancer (GBC) is dismal. This
study aimed to compare the outcomes of adjuvant chemoradiotherapy (ACR) with those of surgery alone (S) and adjuvant chemotherapy (AC).
UNASSIGNED: The Surveillance, Epidemiology, and End Results (SEER) Program database was used to identify patients diagnosed with GBC and undergoing surgery between 2004 and 2015. The patients were divided into the S, AC, and ACR groups according to their treatment. Categorical variables were compared by Pearson\'s chi-square test, and a 1:1:1 propensity score matching analysis (PSM) was performed. Overall survival was assessed by Kaplan-Meier curves with log-rank tests. Subgroup analyses were conducted.
UNASSIGNED: A total of 5451 patients were identified in the SEER database. After PSM, the two-year survival among patients who received S, AC, and ACR was 36%, 39%, and 45%, respectively. ACR was associated with improved two-year survival (p < 0.001), while the survival rates were similar in the AC and S groups (p = 0.127) but better in the ACR group than in the AC group (p = 0.012). Subgroup analyses indicated that while the two-year survival rates did not differ significantly in stage II GBC patients between the groups (all p > 0.05), ACR was associated with significantly improved two-year survival in stage Ⅲa (p = 0.008), Ⅲb (p < 0.001), and Ⅳb (p < 0.001) GBC patients.
UNASSIGNED: The combination of surgery and ACR as the treatment modality provided greater survival benefits for GBC patients, particularly for those with advanced tumor staging.