Takamori Hiroshi, Hiraoka Takehisa, Kanemitsu Keiichiro, Tsuji Tatsuya, Tanaka Hiroshi, Chikamoto Akira, Horino Kei, Beppu Toru, Hirota Masahiko, Baba Hideo
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
J Hepatobiliary Pancreat Surg. 2008;15(6):603-7. doi: 10.1007/s00534-007-1323-5. Epub 2008 Nov 7.
BACKGROUND/PURPOSE: Systemic and/or local recurrence often occurs even after curative resection for pancreatic cancer (PC). To prevent local relapse we adopted an extended radical resection combined with intraoperative radiation therapy in patients with PC, and all the patients were followed for more than 5 years.
We assessed the long-term outcomes of 41 patients who underwent this combined therapy. The cumulative survival curve in this series was depicted using the Kaplan-Meier method. Statistical analyses were performed using the log-rank test.
The actual 5-year survival rate was 14.6%, with a median survival time of 17.6 months. Six patients have been 5-year survivors. Local recurrence occurred in only 2 patients (5.0%). Cancer-related death occurred in 32 patients, 18 of whom had liver metastases. The patients with liver metastases had a significantly shorter survival time than those with other cancer-related causes of death. Patients with n3 lymph node involvement, extrapancreatic nerve plexus invasion, and stage IV disease had significantly poorer prognoses than patients without these characteristics.
Our combined therapy for patients with PC contributed to local control; however, it provided no survival benefit, because of liver metastases.
背景/目的：即使在胰腺癌（PC）进行根治性切除术后，仍常发生全身和/或局部复发。为预防局部复发，我们对胰腺癌患者采用了扩大根治性切除术联合术中放射治疗，并对所有患者进行了5年以上的随访。
我们评估了41例行这种联合治疗患者的长期预后。采用Kaplan-Meier法描绘该系列的累积生存曲线。使用对数秩检验进行统计分析。
实际5年生存率为14.6%，中位生存时间为17.6个月。6例患者存活5年。仅2例患者（5.0%）发生局部复发。32例患者死于癌症相关原因，其中18例有肝转移。有肝转移的患者生存时间明显短于其他癌症相关死亡原因的患者。有N3淋巴结受累、胰腺外神经丛侵犯和IV期疾病的患者预后明显比无这些特征的患者差。
我们对胰腺癌患者的联合治疗有助于局部控制；然而，由于肝转移，它并未提供生存益处。
