Department of Gastroenterology, Surgical Division, Faculty of Medicine, São Paulo University, São Paulo, Brazil.
HPB (Oxford). 2008;10(5):356-62. doi: 10.1080/13651820802140752.
Pancreatic cancer is the fifth leading cause of cancer-related deaths in the world. Operative resection is the only therapeutic option with curative potential for this disease.
The aim of the present study was to correlate clinical and pathologic parameters with survival in patients submitted to pancreatic resection for pancreatic adenocarcinoma.
Surgical resection with curative intent (R0 and R1 resections) was performed in 65 pancreatic cancer patients between 1990 and 2006. The overall results of surgical treatment were retrospectively analyzed and compared with the clinicopathologic features of these patients.
Pylorus-preserving pancreatoduodenectomy was performed in 37 patients (56.9%), classic resection in 35.4%, distal pancreatectomy in 4.6% and total pancreatectomy in 3.6%. The inhospital mortality was 5% (three patients). Postoperative complications occurred in 28 patients (43%). Mean survival and five-year survival rate after curative resection were 27 months and 9.0%, respectively. Sex, TNM stage, tumor differentiation, neural invasion, tumor size and involvement of resection margin were significant prognostic factors on univariate analysis. Multivariate analysis showed tumor differentiation and neural invasion as prognostic factors.
Patients with pancreatic cancer, even those with poor prognostic factors should be given the opportunity of surgical resection with curative intent.
胰腺癌是全球第五大癌症相关死亡原因。手术切除是唯一具有治愈潜力的治疗方法。
本研究旨在分析与接受胰腺腺癌胰切除术患者的生存相关的临床和病理参数。
1990 年至 2006 年间，对 65 例胰腺癌患者进行了根治性手术（R0 和 R1 切除术）。回顾性分析了手术治疗的总体结果，并与这些患者的临床病理特征进行了比较。
37 例（56.9%）患者行保留幽门胰十二指肠切除术，35.4%行经典切除术，4.6%行胰体尾切除术，3.6%行全胰切除术。院内死亡率为 5%（3 例）。28 例（43%）患者发生术后并发症。根治性切除术后的平均生存时间和 5 年生存率分别为 27 个月和 9.0%。单因素分析显示，性别、TNM 分期、肿瘤分化、神经侵犯、肿瘤大小和切缘受累是显著的预后因素。多因素分析显示肿瘤分化和神经侵犯是预后因素。
即使是预后不良的胰腺癌患者，也应给予有治愈可能的手术切除机会。
