Multivariate Analysis Of Recurrence And Long-term Prognosis Of Gallbladder Carcinoma After Radical Resection

Purpose Gallbladder Carcinoma(GBC)is a common malignant tumor of the biliary system,the incidence of which accounts for 60% of the malignant tumors of the biliary system,ranking the 6th in the malignant tumors of the digestive system.It is characterized by insidious onset,high heterogeneity and strong invasiveness.Radical surgical resection is the only chance to cure gallbladder carcinoma.However,the postoperative recurrence rate of GBC is as high as 40-60%,the prognosis is very poor,and the five-year survival rate is 5-20%.In this paper,through retrospective analysis of the clinicopathological data of 161 patients after radical gallbladder cancer surgery,to explore the factors affecting the recurrence and long-term prognosis after radical gallbladder cancer surgery,so as to provide reference for clinical practice.Methods The clinicopathologic data of patients who underwent radical gallbladder carcinoma operation in Zhejiang Provincial People’s Hospital from January 2010 to January 2023 were retrospectively analyzed,including 38 males and 123 females,median age 66 years old,age range 31-88 years old.The survival status of patients was followed up by telephone.Through the comparison of patients’ general data,tumor characteristics and surgical conditions,univariate and multivariate analysis was carried out by statistical software to obtain the risk factors affecting the recurrence and long-term prognosis of gallbladder cancer after radical resection.Results Univariate analysis of postoperative recurrence showed CA199 level(P <0.001),surgical method(P < 0.001),tumor size(P < 0.001),T stage(P < 0.001),N stage(P < 0.001),tumor invasion of nerve(P=0.006),tumor invasion of vessel(P <0.001),and tumor differentiation degree(P < 0.001)were important factors affecting the recurrence of gallbladder cancer after radical surgery,but age,gender,preoperative albumin,preoperative ALT level,preoperative AST level,preoperative TBi L level,unexpected gallbladder cancer,whether to receive postoperative chemotherapy,tumor pathological type were not important factors affecting the recurrence of gallbladder cancer after radical surgery(P > 0.05).It was concluded that T stage(P < 0.001),vascular invasion(P=0.049)and differentiation degree(P=0.002)were independent risk factors for recurrence after radical gallbladder cancer.Univariate analysis of long-term prognosis showed CA199 level(P=0.008),preoperative AST level(P=0.046),preoperative TBIL level(P=0.011),surgical method(P=0.004)(Figure 9),tumor size(P=0.002),T stage(P < 0.001),N stage(P < 0.001).,tumor invasion of nerve(P=0.032),tumor invasion of vasculature(P=0.003),tumor differentiation degree(P <0.001)are important factors affecting the survival time after radical gallbladder cancer surgery.Multivariate analysis showed that T stage(P=0.003),N stage(P=0.006)and degree of differentiation(P < 0.001)were independent risk factors for long-term prognosis after radical gallbladder carcinoma surgery.Conclusion 1."T3 stage,vascular invasion and poorly differentiated tumors" are independent risk factors for recurrence of gallbladder cancer after radical surgery.2."T3stage,N1～2 staging and poorly differentiated tumors" are independent risk factors for long-term survival and prognosis after radical gallbladder carcinoma surgery.