Tas F, Aykan F, Alici S, Kaytan E, Aydiner A, Topuz E
Institute of Oncology, University of Istanbul, Istanbul, Turkey.
Am J Clin Oncol. 2001 Dec;24(6):547-50. doi: 10.1097/00000421-200112000-00003.
In this study, our aim was to investigate the impact of various prognostic factors on survival in patients with pancreatic carcinoma. The group consisted of 127 cases with adenocarcinoma histologically. The patients had a median age of 58 years, and 81 (64%) were male. The median survival time of the whole group was 7 months, and the 4-year survival rate was 18%. The median survival duration of the patients without metastases was 8 months, and the survival rate at 1 year was 37.5% and 7.2% at 5 years. It was associated with improved survival compared with the cases with metastatic disease (p < 0.0001). In univariate analysis, decreased performance status (p = 0.0009) and unresectability of tumor (p < 0.0001) were associated with poor outcome. However, only surgery was found to be a statistically significant parameter in multivariate analysis (p = 0.002). The median survival duration of patients with metastases was 5 months, and the 1-year survival rate was 10%. Age younger than 60 years (p = 0.04), decreased serum hemoglobin levels (p = 0.04), and elevated lactic dehydrogenase (LDH) levels (p = 0.0001) were associated with a significantly shorter survival rate. In the Cox model, a high serum LDH level was the only independent unfavorable prognostic factor (p = 0.001). In conclusion, surgical intervention in the group without metastases and serum LDH levels in the group with metastases were the most important prognostic factors influencing survival. Pretreatment serum LDH determinations may provide a useful means of stratifying patient populations when comparing treatment programs for advanced pancreatic cancer.
在本研究中，我们的目的是调查各种预后因素对胰腺癌患者生存的影响。该组由127例组织学确诊为腺癌的病例组成。患者的中位年龄为58岁，其中81例（64%）为男性。全组的中位生存时间为7个月，4年生存率为18%。无转移患者的中位生存时间为8个月，1年生存率为37.5%，5年生存率为7.2%。与有转移疾病的病例相比，其生存情况有所改善（p<0.0001）。单因素分析中，体能状态下降（p = 0.0009）和肿瘤不可切除（p<0.0001）与不良预后相关。然而，多因素分析中仅手术被发现是具有统计学意义的参数（p = 0.002）。有转移患者的中位生存时间为5个月，1年生存率为10%。年龄小于60岁（p = 0.04）、血清血红蛋白水平降低（p = 0.04）和乳酸脱氢酶（LDH）水平升高（p = 0.0001）与显著较短的生存率相关。在Cox模型中，高血清LDH水平是唯一独立的不良预后因素（p = 0.001）。总之，无转移组的手术干预和有转移组的血清LDH水平是影响生存的最重要预后因素。在比较晚期胰腺癌的治疗方案时，治疗前血清LDH测定可为患者群体分层提供一种有用的方法。
