マツナガ　ユウタロウ   Matsunaga Yuutarou   松永　雄太郎    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Examination of Prognostic Factors Affecting Long-Term Survival of Patients with Stage 3/4 Gallbladder Cancer without Distant Metastasis.
掲載誌名	正式名：Cancers 略　 称：Cancers (Basel) ISSNコード：20726694/20726694
掲載区分	国外
巻・号・頁	12(8),pp.2073
著者・共著者	HIGUCHI Ryota†, YAZAWA Takehisa, UEMURA Shuichiro, MATSUNAGA Yutaro, OTA Takehiro, ARAIDA Tatsuo, FURUKAWA Toru, YAMAMOTO Masakazu*
発行年月	2020/07
概要	In advanced gallbladder cancer (GBC) radical resection, if multiple prognostic factors are present, the outcome may be poor; however, the details remain unclear. To investigate the poor prognostic factors affecting long-term surgical outcome, we examined 157 cases of resected stage 3/4 GBC without distant metastasis between 1985 and 2017. Poor prognostic factors for overall survival and treatment outcomes of a number of predictable preoperative poor prognostic factors were evaluated. The surgical mortality was 4.5%. In multivariate analysis, blood loss, poor histology, liver invasion, and ≥4 regional lymph node metastases (LNMs) were independent prognostic factors for poor surgical outcomes; invasion of the left margin or the entire area of the hepatoduodenal ligament and a Clavien-Dindo classification ≥3 were marginal factors. The analysis identified outcomes of patients with factors that could be predicted preoperatively, such as liver invasion ≥5 mm, invasion of the left margin or the entire area of the hepatoduodenal ligament, and ≥4 regional LNMs. Thus, the five-year overall survival was 54% for zero factors, 34% for one factor, and 4% for two factors (p < 0.05). A poor surgical outcome was likely when two or more factors were predicted preoperatively; therefore, new treatment strategies are required for such patients.
DOI	10.3390/cancers12082073
PMID	32726993