Fristrup Claus Wilki, Pless Torsten, Nielsen Henning Overgaard, Hovendal Claus, Mortensen Michael Bau
Skovalléen 31, DK-5250 Odense SV.
Ugeskr Laeger. 2008 Dec 1;170(49):4040-4.
Cancer in the upper gastrointestinal tract has a poor prognosis and the best results are obtained by the few resectable patients. Earlier studies indicated that Danish survival might be inferior to that of other Scandinavian countries. The aim of this study was to evaluate the long-term survival after curative resections for these patients.
All patients referred for treatment of cancer of the oesophagus, stomach or pancreas were prospectively included. Data were registered with regard to pre-therapeutic examination and operative results. Deceased patients were found by comparison with the Danish Central Personal Register in January 2007.
A total of 398 patients were included, of whom 164 were found to be possibly resectable. In total 118 (30%) patients underwent complete surgical resection. The median survival period for patients with oesophageal cancer, stomach cancer and pancreatic cancer was: 22.7 months (18.7-39.4), above 36 months and 31.4 months (19.2-) respectively. The observed 3-year survival was 40% (26-53), 56% (38-71) and 47% (31-62). The estimated 5-year survival was 35% (22-48), 56% (39-72), 43% (27-59).
The observed long-term survival was comparable to international results. However, only one third of the patients were eligible for complete surgical resection. It is therefore important to establish a close cooperation between surgeons and oncologist to improve the overall survival for this group of patients.
上消化道癌症预后较差,少数可切除患者能取得最佳治疗效果。早期研究表明,丹麦患者的生存率可能低于其他斯堪的纳维亚国家。本研究旨在评估这些患者根治性切除术后的长期生存率。
前瞻性纳入所有因食管癌、胃癌或胰腺癌前来治疗的患者。记录术前检查和手术结果的数据。通过与2007年1月丹麦中央个人登记处对比,查找已故患者。
共纳入398例患者,其中164例被认为可能可切除。总计118例(30%)患者接受了完整的手术切除。食管癌、胃癌和胰腺癌患者的中位生存期分别为:22.7个月(18.7 - 39.4)、超过36个月和31.4个月(19.2 - )。观察到的3年生存率分别为40%(26 - 53)、56%(38 - 71)和47%(31 - 62)。估计的5年生存率分别为35%(22 - 48)、56%(39 - 72)、43%(27 - 59)。
观察到的长期生存率与国际结果相当。然而,只有三分之一的患者适合进行完整的手术切除。因此,外科医生和肿瘤学家之间建立密切合作对于提高这组患者的总体生存率非常重要。