Background: Gallbladder cancer (GBC) is an uncommon cancer. This study aimed to determine the outcomes of GBC in relation to geographic, demographic, and clinical factors in a Canadian province from 2000 to 2019. Methods: This population-based retrospective cohort study included all patients diagnosed with gallbladder cancer (GBC) in Saskatchewan, Canada, from 2000 to 2019. Cox proportional multivariate regression analysis was conducted to identify factors associated with poorer outcomes. Results: In total, 331 patients with a median age of 74 years and male–female ratio of 1:2 were identified. Of these patients, 305 (92%) had a pathological diagnosis of GBC. Among patients with documented staging data, 64% had stage IV disease. A total of 217 (66%) patients were rural residents, and 149 (45%) were referred to a cancer center. The multivariate analysis for patients with stage I–III GBC showed that stage III disease [hazard ratio (HR), 2.63; 95% confidence interval (CI), 1.09–6.34)] and urban residence (HR, 2.20; 95% CI, 1.1–4.39) were correlated with inferior disease-free survival. For all patients, stage IV disease (HR, 3.02; 95% CI, 1.85–4.94), no referral to a cancer center (HR, 2.64; 95% CI, 1.51–4.62), lack of surgery (HR, 1.63; 95% CI, 1.03–2.57), a neutrophil–lymphocyte ratio of >3.2 (HR, 1.57; 1.05–2.36), and age of ≥70 years (HR, 1.51; 95% CI, 1.04–2.19) were correlated with inferior overall survival. Conclusions: In this real-world context, the majority of patients with GBC were diagnosed at a late stage and were not referred to a cancer center. For those with early-stage GBC, living in an urban area and having stage III disease were linked to worse outcomes. Across all stages of GBC, stage IV disease, older age, absence of surgery, lack of referral to a cancer center, and a high neutrophil-to-lymphocyte ratio were associated with poorer survival.
背景：胆囊癌是一种相对少见的恶性肿瘤。本研究旨在分析2000年至2019年间加拿大某省份胆囊癌患者的预后与地理、人口及临床因素的关系。方法：这项基于人群的回顾性队列研究纳入了2000年至2019年加拿大萨斯喀彻温省所有确诊为胆囊癌的患者。采用Cox比例多变量回归分析确定与不良预后相关的因素。结果：共纳入331例患者，中位年龄74岁，男女比例为1:2。其中305例（92%）经病理学确诊为胆囊癌。在有明确分期记录的患者中，64%为IV期疾病。217例（66%）患者居住于农村地区，149例（45%）被转诊至癌症中心。针对I-III期胆囊癌患者的多变量分析显示，III期疾病[风险比（HR）为2.63；95%置信区间（CI）为1.09-6.34]和城市居住地（HR为2.20；95% CI为1.1-4.39）与较差的无病生存期相关。在所有患者中，IV期疾病（HR为3.02；95% CI为1.85-4.94）、未转诊至癌症中心（HR为2.64；95% CI为1.51-4.62）、未接受手术治疗（HR为1.63；95% CI为1.03-2.57）、中性粒细胞-淋巴细胞比值>3.2（HR为1.57；95% CI为1.05-2.36）以及年龄≥70岁（HR为1.51；95% CI为1.04-2.19）与较差的总体生存期相关。结论：在真实世界临床实践中，大多数胆囊癌患者在晚期才被确诊且未转诊至癌症中心。对于早期胆囊癌患者，居住在城市地区和处于III期疾病与不良预后相关。在所有分期的胆囊癌患者中，IV期疾病、高龄、未接受手术、未转诊至癌症中心以及高中性粒细胞-淋巴细胞比值均与较差的生存结局相关。
肿瘤(癌症)患者之家