Fujino Yasuhiro, Sakai Tetsuya, Kuroda Yoshikazu
Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
J Gastroenterol. 2008;43(3):233-8. doi: 10.1007/s00535-007-2147-4. Epub 2008 Mar 29.
The prognosis of patients with advanced pancreatic cancer remains very poor. This study was designed to evaluate palliative pancreatic resection with postoperative gemcitabine chemotherapy.
A total of 127 patients underwent palliative pancreatectomy or palliative nonresectable treatment with gemcitabine at Kobe University Hospital and were analyzed.
The median survival of patients receiving palliative pancreatectomy with gemcitabine was 15 months, and the 1- and 3-year survival rates were 60% and 13%, respectively, while that of patients receiving gemcitabine alone was only 8 months, and their 1- and 3-year survival rates were 26% and 0%. Multivariate analysis showed that gemcitabine was the strongest factor in survival, and no distant metastasis and pancreatectomy were also significant factors. In addition, the median survival of patients undergoing microscopically incomplete resection with gemcitabine was 22 months, and the 1- and 3-year survival rates were 60% and 40%. Pancreatectomy with gemcitabine improved the performance status 3 months after surgery, with longer survival compared with the gemcitabine alone group.
Microscopically incomplete pancreatectomy with postoperative gemcitabine chemotherapy has a possible role in advanced pancreatic cancer.
晚期胰腺癌患者的预后仍然很差。本研究旨在评估姑息性胰腺切除术后吉西他滨化疗的效果。
对127例在神户大学医院接受姑息性胰腺切除术或吉西他滨姑息性非切除治疗的患者进行分析。
接受吉西他滨姑息性胰腺切除术患者的中位生存期为15个月，1年和3年生存率分别为60%和13%，而单纯接受吉西他滨治疗的患者中位生存期仅为8个月，1年和3年生存率分别为26%和0%。多因素分析显示，吉西他滨是影响生存的最强因素，无远处转移和胰腺切除术也是显著因素。此外，接受吉西他滨治疗的显微镜下切除不完全患者的中位生存期为22个月，1年和3年生存率分别为60%和40%。吉西他滨联合胰腺切除术改善了术后3个月的功能状态，与单纯吉西他滨组相比生存期更长。
显微镜下不完全胰腺切除术联合术后吉西他滨化疗在晚期胰腺癌治疗中可能具有一定作用。
