Ferrone Cristina R, Brennan Murray F, Gonen Mithat, Coit Daniel G, Fong Yuman, Chung Sun, Tang Laura, Klimstra David, Allen Peter J
Department of Surgery, Memorial Sloan-Kettering Cancer Center, Howard 1223, 1275 York Avenue, New York, NY 10021, USA.
J Gastrointest Surg. 2008 Apr;12(4):701-6. doi: 10.1007/s11605-007-0384-8. Epub 2007 Nov 20.
Most reports of patients undergoing resection for pancreatic adenocarcinoma report estimated (actuarial) 5-year survival rates. Actual 5-year survival is rarely described, and factors associated with long-term survival are not well described.
Review of a prospectively maintained database identified 618 patients who underwent resection for pancreatic adenocarcinoma between 1/1983-1/2001. Patient, tumor, and treatment-related variables were assessed for their association with 5-year survival.
There were 75 patients who survived >5 years after resection (75 out of 618, 12%), and 18 patients who survived >10 years (18 out of 352, 5%). Patient age, gender, and tumor location were not associated with 5-year survival, whereas early American Joint Committee on Cancer (AJCC) stage (p < 0.001) and negative margins (p = 0.001) were associated with 5-year survival. Patients with stage IA disease had an actual 5 year survival of 26%. Median follow-up was 108 months. Recurrent disease developed in 38 patients (51%) and all died from disease. Adjuvant therapy was received by 21% (16 out of 75), and tumors were moderately differentiated in 58% (42 out of 75) and had a median size of 2.8 cm (0.8-13 cm).
Actual 5-year survival after resection of pancreatic adenocarcinoma was 12%. AJCC stage and negative margins were the only significant predictors of long-term survival. Early detection and intervention for patients with pancreatic cancer is crucial.
大多数关于胰腺癌切除术患者的报告都报道了估计（精算）的5年生存率。实际的5年生存率很少被描述，与长期生存相关的因素也没有得到很好的描述。
回顾一个前瞻性维护的数据库，确定了1983年1月至2001年1月期间接受胰腺癌切除术的618例患者。评估患者、肿瘤和治疗相关变量与5年生存的相关性。
有75例患者在切除术后存活超过5年（618例中的75例，12%），18例患者存活超过10年（352例中的18例，5%）。患者年龄、性别和肿瘤位置与5年生存无关，而美国癌症联合委员会（AJCC）早期分期（p<0.001）和切缘阴性（p = 0.001）与5年生存相关。IA期疾病患者的实际5年生存率为26%。中位随访时间为108个月。38例患者（51%）出现复发疾病，均死于该疾病。21%（75例中的16例）接受了辅助治疗，58%（75例中的42例）肿瘤为中度分化，中位大小为2.8 cm（0.8 - 13 cm）。
胰腺癌切除术后的实际5年生存率为12%。AJCC分期和切缘阴性是长期生存的唯一重要预测因素。对胰腺癌患者进行早期检测和干预至关重要。
