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Long-term prognosis of patients with gallbladder carcinoma after curative-intent resection based on changes in the ratio of carbohydrate antigen 19-9 to total bilirubin (CA19-9/TB): a multicenter retrospective cohort study.

التفاصيل البيبلوغرافية
العنوان: Long-term prognosis of patients with gallbladder carcinoma after curative-intent resection based on changes in the ratio of carbohydrate antigen 19-9 to total bilirubin (CA19-9/TB): a multicenter retrospective cohort study.
المؤلفون: Li XL; Department of Hepatobiliary Surgery, Southwest Hospital., Liu ZP; Department of Hepatobiliary Surgery, Southwest Hospital.; Hepato-Pancreato-Biliary Center, Tsinghua Changgung Hospital, Tsinghua University, Beijing., Su XX; Department of Hepatobiliary Surgery, Southwest Hospital., Gong Y; Department of Hepatobiliary Surgery, Southwest Hospital., Yang YS; Department of Hepatobiliary Surgery, Southwest Hospital.; Department of Second Surgery, 96604 Army Hospital., Zhao XL; Department of Hepatobiliary Surgery, Southwest Hospital., Li ZM; Department of Hepatobiliary Surgery, Southwest Hospital., Ding JJ; Department of Hepatobiliary Surgery, Southwest Hospital., Zhu Y; Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Zhejiang University., Yin DL; Department of Hepatobiliary Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei., Yu C; Department of Hepatobiliary Surgery, Affiliated Hospital of Guizhou Medical University, Guizhou., Zhou JX; Department of Hepatobiliary Pancreatic Surgery, Henan Provincial Tumor Hospital, Zhengzhou., Zhang D; Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University., Ding R; Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an., Chen W; Department of Hepatobiliary Surgery, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan., Cheng Y; Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing., Yue P; Department of Hepatobiliary Surgery, Lanzhou University First Hospital, Lanzhou., Wang ZR; Department of General Surgery, 903rd Hospital of People's Liberation Army, Hangzhou., Zhang YQ; Department of Health Statistics, College of Military Preventive Medicine, Third Military Medical University (Army Medical University)., Jiang Y; Department of Hepatobiliary Surgery, Southwest Hospital., Yin XY; Department of Hepatobiliary Surgery, Southwest Hospital., Bai J; Department of Hepatobiliary Surgery, Southwest Hospital., Dai HS; Department of Hepatobiliary Surgery, Southwest Hospital., Lau WY; Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, People's Republic of China., Chen ZY; Department of Hepatobiliary Surgery, Southwest Hospital.
مؤلفون مشاركون: Biliary Surgery Branch of Elite Group of Chinese Digestive Surgery (EGCDS)
المصدر: International journal of surgery (London, England) [Int J Surg] 2024 Jun 01; Vol. 110 (6), pp. 3580-3590. Date of Electronic Publication: 2024 Jun 01.
نوع المنشور: Journal Article; Multicenter Study
اللغة: English
بيانات الدورية: Publisher: Wolters Kluwer Health, Inc Country of Publication: United States NLM ID: 101228232 Publication Model: Electronic Cited Medium: Internet ISSN: 1743-9159 (Electronic) Linking ISSN: 17439159 NLM ISO Abbreviation: Int J Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: 2023- : [Philadelphia] : Wolters Kluwer Health, Inc.
Original Publication: London : Surgical Associates Ltd., c2004-
مواضيع طبية MeSH: Gallbladder Neoplasms*/surgery , Gallbladder Neoplasms*/blood , Gallbladder Neoplasms*/mortality , Gallbladder Neoplasms*/pathology , Bilirubin*/blood , CA-19-9 Antigen*/blood, Humans ; Retrospective Studies ; Female ; Male ; Middle Aged ; Aged ; Prognosis ; Adult
مستخلص: Background: The prognostic value of carbohydrate antigen 19-9 (CA19-9) is known to be affected by elevated bilirubin levels in patients with gallbladder carcinoma (GBC). The clinical significance of changes in the ratio of CA19-9 levels to total bilirubin (TB) levels in patients with GBC after curative-intent resection remains unknown. The aim of this study was to determine the prognostic value of changes in preoperative and postoperative CA19-9/TB ratio in these patients.
Methods: Prospectively collected data on consecutive patients who underwent curative-intent resection for GBC between January 2015 and December 2020 stored in a multicenter database from 10 hospitals were analyzed in this retrospective cohort study. Based on the adjusted CA19-9 defined as the ratio of CA19-9 to TB, and using 2×10 3  U/µmol as the upper normal value, patients were divided into a normal group (with normal preoperative and postoperative adjusted CA19-9), a normalization group (with abnormal preoperative but normal postoperative adjusted CA19-9), and a non-normalization group (with abnormal postoperative adjusted CA19-9). The primary outcomes were overall survival (OS) and recurrence-free survival (RFS). The log-rank test was used to compare OS and RFS among the groups. The Cox regression model was used to determine factors independently associated with OS and RFS.
Results: The normal group ( n =179 patients) and the normalization group ( n =73 patients) had better OS and RFS than the non-normalization group ( n =65 patients) (the 3-year OS rates 72.0%, 58.4% and 24.2%, respectively; the RFS rates 54.5%, 25.5% and 11.8%, respectively; both P <0.001). There were no significant differences between the normal and the normalization groups in OS and RFS (OS, P =0.255; RFS, P =0.130). Cox regression analysis confirmed that the non-normalization group was independently associated with worse OS and RFS. Subgroup analysis revealed that the non-normalization group of patients who received adjuvant therapy had significantly improved OS and RFS as compared to those who did not receive adjuvant therapy (OS, P =0.025; RFS, P =0.003).
Conclusions: Patients with GBC who underwent curative-intent surgical resection with postoperative abnormal levels of adjusted CA19-9 (the CA19-9/TB ratio) were associated with poorer long-term survival outcomes. Adjuvant therapy after surgery improved the long-term outcomes of these patients.
(Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
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المشرفين على المادة: RFM9X3LJ49 (Bilirubin)
0 (CA-19-9 Antigen)
تواريخ الأحداث: Date Created: 20240416 Date Completed: 20240627 Latest Revision: 20240627
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC11175767
DOI: 10.1097/JS9.0000000000001379
PMID: 38626431
قاعدة البيانات: MEDLINE
الوصف
تدمد:1743-9159
DOI:10.1097/JS9.0000000000001379