Sener S F, Fremgen A, Menck H R, Winchester D P
Commission on Cancer, American College of Surgeons, Chicago, IL 60611-3211, USA.
J Am Coll Surg. 1999 Jul;189(1):1-7. doi: 10.1016/s1072-7515(99)00075-7.
The National Cancer Database is an electronic registry system sponsored jointly by the American College of Surgeons Commission on Cancer and the American Cancer Society. Patients diagnosed with pancreatic adenocarcinoma from 1985 to 1995 were analyzed for trends in stage of disease, treatment patterns, and outcomes.
Seven annual requests for data were issued by the National Cancer Database from 1989 through 1995. Data on 100,313 patients were voluntarily submitted using a standardized reporting format.
The anatomic site distribution was: head, 78%; body, 11%; and tail, 11%. The ratios of limited to advanced disease (Stage I/Stage IV) were 0.70 for tumors in the head, 0.24 for body tumors, and 0.10 for tail tumors. Of all patients, 83% did not have a surgical procedure and 58% did not have cancer-directed treatment. Resection was done for 9,044 (9%) patients, including 22% of those with Stage I disease. The overall 5-year survival rate was 23.4% for patients who had pancreatectomy, compared with 5.2% for those who had no cancer-directed treatment.
Overall survival rates for pancreatic cancer have not changed in 2 decades. A small minority of patients presented with limited, resectable disease, but the best survival rates per stage were achieved after surgical resection. Five-year survival rates after resection reported herein corroborated the improved survival rates of more recent large, single institution studies.
国家癌症数据库是一个由美国外科医师学会癌症委员会和美国癌症协会联合赞助的电子登记系统。对1985年至1995年诊断为胰腺腺癌的患者进行疾病分期、治疗模式和预后趋势分析。
1989年至1995年期间，国家癌症数据库每年发布7次数据请求。100313例患者的数据通过标准化报告格式自愿提交。
解剖部位分布为：胰头78%；胰体11%；胰尾11%。胰头肿瘤局限期与进展期（I期/IV期）的比例为0.70，胰体肿瘤为0.24，胰尾肿瘤为0.10。所有患者中，83%未接受手术，58%未接受针对癌症的治疗。9044例（9%）患者接受了切除术，其中I期疾病患者占22%。接受胰腺切除术的患者总体5年生存率为23.4%，未接受针对癌症治疗的患者为5.2%。
胰腺癌的总体生存率在20年中没有变化。少数患者表现为局限性、可切除疾病，但各期最佳生存率是在手术切除后实现的。本文报告的切除术后5年生存率证实了近期大型单机构研究中生存率的提高。
