Diagnosis,treatment and prognosis of gallbladder cancer in China from 2010 to 2017:a report of 7874 cases
WANG Yi-jun
SUN Xu-heng
FENG Jia-yi
REN Tai
JIA Zi-heng
LI Lin
LI Xue-chuan
LIU Ke
LIU Li-guo
LIU Zhao-nan
PU Peng
TAO Wen-qi
YAN Wei-kang
YANG Mao
YANG Ming-jie
ZHENG Zhi-yuan
ZOU Lu
CHEN Tao
CHEN Wei
GENG Ya-jun
HE Min
LI Yong-sheng
WANG Hui
WU Wen-guang
YANG Lin-hua
ZHANG Jun-feng
WU Xiang-song
GU Jun
BA Sang
BAI Jun-chao
CAI Hong-yu
CAO Hong
CAO Jing-yu
CHEN Xiao-liang
CUI Yun-fu
DAI Chao-liu
DANG Xue-yi
DUAN Shao-bin
FENG Jian
GU Jian-feng
HAN Wei
HAO Ji-hui
HE Song-qing
ZHANG Bin
HU Xiao-qiang
JIANG Xiao-qing
JIN Hui-han
LI Bing
LI Gui-chen
LI Guo-song
LI Ming-zhang
LI Qi-yun
LI Zhi-zhen
LIU Chang-jun
LIU Chao
LIU Fu-bao
LIU Jian-sheng
LIU Jing-feng
LIU Jun
LIU Lian-xin
LV Wen-cai
NIE Gao-hua
QI Ying-hua
QIAN Ye-ben
SHAO Cheng-hao
SUN Bei
WANG Chuan-lei
WANG Huai-zhi
WANG Jun-hua
WANG Lei
WANG Lin
WANG Qi
WANG Yi
WANG Zhi-qiang
WU Bu-qiang
XU Jun-ming
XU Min
YAN Jun
YANG Jia-hua
YANG Tian
YU Ding-gang
YUAN Yu-feng
ZHANG Lei
ZHANG Qi-yu
ZHANG Tong
ZHANG Xuan
ZHANG Xue-li
ZHANG Xue-wen
ZHAO Hui
ZHENG Jin-fang
ZHU Chun-fu
ZHU Hai-hong
ZUO Shi
GENG Zhi-min
GONG Wei
LI Mao-lan
ZHANG Wei
LIU Ying-bin
Abstract：Objective To review,summarize,and discuss the diagnosis,treatment,and prognosis of gallbladder cancer in China between 2010 and 2017.Methods Electronic health records of 7874 patients diagnosed with gallbladder cancer from 49 hospitals were collected and structured from January 2010 to December 2017.Observational indicators included the year of diagnosis,age at first diagnosis,the administrative district of the diagnosing hospital,the rank of the diagnosing hospital,the annual number of gallbladder cancer diagnosed at the diagnosing hospital,sex,ultrasound results,CT results,MRI results,CEA levels,CA19-9 levels,CA125 levels,diagnostic criteria,the timing of diagnosis,whether surgical treatment was received,whether the surgery met the radical treatment standard,TNM staging,and whether adjuvant treatment was received.Quantitative data were tested for normal distribution using the Kolmogorov-Smirnov test,described by mean±standard deviation if normally distributed,and compared using the t-test;non-normally distributed data were described by median(first and third quartiles)and compared using the U-test.Categorical data were described by frequency(percentage of total)and compared using the Chi-squared test.Univariate analysis was performed using logistic regression,and multivariate analysis was conducted using stepwise logistic regression.Overall survival rates were calculated using the life table,survival data were described by median survival time(95％confidence interval),comparisons of overall survival rates between groups at certain time points were conducted using the z-test,and survival curves were plotted using the Kaplan-Meier method,with survival analysis performed using the Log-rank test.Results The number of gallbladder cancer cases has continuously increased over time,with more females than males,and the median diagnosis age is 64 years old.The proportion of patients undergoing enhanced CT,enhanced MRI,tumor marker CEA,CA19-9,and CA125 exams has steadily increased,as has the detection rate of enhanced CT,enhanced MRI,and MRCP.Factors such as age at first diagnosis,sex,the administrative district of the diagnosing hospital,the rank of the diagnosing hospital,the annual number of gallbladder cancer diagnosed at the diagnosing hospital,ultrasound,plain and enhanced CT scans,enhanced MRI scans,MRCP scans,and tumor markers CEA,CA19-9,and CA125 have played a significant role in the early diagnosis of gallbladder cancer.Independent influencing factors for early gallbladder cancer diagnosis include the administrative district of the diagnosing hospital,the rank of the diagnosing hospital,the annual number of gallbladder cancer diagnosed at the diagnosing hospital,sex,enhanced CT scans,and CA125 levels.The median survival time of patients in the study was 334 days,with overall survival rates at six months of 66.0％,one year of 48.0％,two years of 31.3％,three years of 22.2％,and five years of 11.2％,and the survival rates rapidly decreased as tumor TNM stages increased.For patients with resectable gallbladder cancer who underwent radical surgical treatment,the median survival time was 699 days,with overall survival rates at six months of 88.0％,one year of 71.6％,two years of 48.6％,three years of 33.8％,and five years of 17.6％.It's also found that the year of diagnosis,age at first diagnosis,the administrative district of the diagnosing hospital,the rank of the diagnosing hospital,the annual number of gallbladder cancer diagnosed at the diagnosing hospital,preoperative serum tumor markers CEA,CA19-9,CA125 levels,whether surgical treatment was received,whether the surgery met radical treatment standards,and TNM staging had a significant impact on the overall survival time of patients with gallbladder cancer.Conclusion The standardization of diagnosis and treatment for gallbladder cancer in China has greatly improved over time,but the epidemiological characteristics and corresponding causes still require further research.For gallbladder cancer,there is substantial room for improvement in the comprehensive treatment methods and overall survival outcomes,and more attention and effort need to be devoted to the comprehensive treatment.
Keywords：gallbladder cancerpreoperative diagnosissurgical treatmentcomprehensive treatmentepidemiologyprognosis
Publication Date：2024-09-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：18( 1038-1054,1061 )