Clinical Characteristics Of Patients With Gallbladder Adenocarcinoma With Better Prognosis

Objective: To investigate the clinical characteristics of patients with gallbladder adenocarcinoma with better prognosis.Methods: Retrospective analysis of the clinical and pathological data of patients who underwent surgical treatment and were pathologically confirmed as primary gallbladder adenocarcinoma in the Second Affiliated Hospital of Kunming Medical University from July 01,2013 to December 31,2019.The median survival time was calculated to determine the clinical cut-off value.The patients were divided into a poor prognosis group and a better prognosis group.The differences between the two groups in preoperative related conditions,surgical methods,and postoperative clinicopathological features were compared.The results of univariate analysis with statistical significance were analyzed by binary Logistic regression to determine the clinical characteristics of patients with gallbladder adenocarcinoma with better prognosis.Results: A total of 190 patients were included,including 60 males and 130 females.The age range was 35-86(years old).The overall median survival time was 16months(95 % confidence interval : 9.568-22.432).The 1-year,3-year and 5-year survival rates were 56.8 %,38.1 % and 34.3 %,respectively.There were 94 patients in the good prognosis group and 96 patients in the poor prognosis group.The patients in the good prognosis group were mainly due to upper abdominal discomfort and gallbladder space-occupying lesions found in physical examination.MRI showed a lower positive rate of gallbladder cancer in imaging examination(P < 0.05).B-ultrasound,CT and MRI showed a significantly lower rate of invasion of surrounding organs and abdominal lymph node metastasis(P < 0.05).Univariate analysis showed that there were significant differences in CEA,CA19-9,CEA combined with CA19-9,surgical method,tumor pathological classification,tumor location,tumor size,tumor differentiation,nerve invasion,peripheral fibrous fat invasion,vascular tumor thrombus,postoperative T stage,and postoperative N stage(P < 0.05).Binary logistic regression multivariate analysis showed that CA19-9 ≤37(ku / L),radical surgery,postoperative TI / II stage,and negative vascular tumor thrombus were independently associated with better postoperative prognosis in patients with primary gallbladder adenocarcinoma(P < 0.05).Conclusion(s): The overall survival rate of patients with primary gallbladder adenocarcinoma is low,and the median survival time is short.The patients with better prognosis are mainly due to upper abdominal discomfort and physical examination.The positive rate of MRI in preoperative imaging examination suggests that the positive rate of gallbladder cancer is lower,and the positive rate of B-ultrasound,CT and MRI suggests that the invasion of surrounding organs and lymph node metastasis are lower.CA19-9,surgical method,postoperative T stage and vascular tumor thrombus are closely related to prognosis.