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本文引用的文献

1
[Prospective evaluation of ultrasonography, multi-slice spiral CT, endoscopic ultrasonography, and magnetic resonance imaging in assessment of TNM staging and assessment of resectability in pancreatic carcinoma].超声检查、多层螺旋CT、内镜超声检查及磁共振成像在胰腺癌TNM分期评估及可切除性评估中的前瞻性研究
Zhonghua Yi Xue Za Zhi. 2008 Nov 4;88(40):2829-32.
2
Staging of pancreatic adenocarcinoma by imaging studies.通过影像学检查对胰腺腺癌进行分期
Clin Gastroenterol Hepatol. 2008 Dec;6(12):1301-8. doi: 10.1016/j.cgh.2008.09.014. Epub 2008 Sep 27.
3
The impact of splenectomy on outcomes after distal and total pancreatectomy.脾切除术对胰体尾切除术和全胰切除术后结局的影响。
World J Surg Oncol. 2007 Jun 2;5:61. doi: 10.1186/1477-7819-5-61.
4
Spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein.保留脾动脉和静脉的保脾远端胰腺切除术。
World J Gastroenterol. 2007 Mar 14;13(10):1493-9. doi: 10.3748/wjg.v13.i10.1493.
5
[Surgical effect of malignant tumor of body and tail of the pancreas: compare with pancreatic head cancer].[胰体尾恶性肿瘤的手术效果:与胰头癌比较]
Zhonghua Wai Ke Za Zhi. 2007 Jan 1;45(1):30-3.
6
Cancer statistics, 2007.2007年癌症统计数据。
CA Cancer J Clin. 2007 Jan-Feb;57(1):43-66. doi: 10.3322/canjclin.57.1.43.
7
One thousand consecutive pancreaticoduodenectomies.一千例连续的胰十二指肠切除术。
Ann Surg. 2006 Jul;244(1):10-5. doi: 10.1097/01.sla.0000217673.04165.ea.
8
[Surgical therapy of tumor of body and tail of pancreas: report of 117 cases].[胰腺体尾部肿瘤的外科治疗:117例报告]
Zhonghua Wai Ke Za Zhi. 2006 Mar 1;44(5):333-5.
9
Analysis of long-term survivors after surgical resection for pancreatic cancer.胰腺癌手术切除后长期存活者的分析
Pancreas. 2006 Apr;32(3):271-5. doi: 10.1097/01.mpa.0000202953.87740.93.
10
Is there a role for staging laparoscopy in patients with locally advanced, unresectable pancreatic adenocarcinoma?对于局部晚期、无法切除的胰腺腺癌患者,分期腹腔镜检查有作用吗?
J Gastrointest Surg. 2004 Dec;8(8):1068-71. doi: 10.1016/j.gassur.2004.09.026.

胰体尾恶性肿瘤的根治性切除与预后。

Radical resection and outcome for malignant tumors of the pancreatic body and tail.

机构信息

Department of General Surgery, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, Zhejiang Province, China.

出版信息

World J Gastroenterol. 2009 Nov 14;15(42):5346-51. doi: 10.3748/wjg.15.5346.

DOI:10.3748/wjg.15.5346
PMID:19908345
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2776864/
Abstract

AIM

To analyze the factors influencing radical (R0) resection rate and surgical outcome for malignant tumor of the pancreatic body and tail.

METHODS

The clinical and operative data and follow-up results of 214 pancreatic body and tail cancer patients were analyzed retrospectively.

RESULTS

One hundred and twenty/214 pancreatic body and tail cancer patients underwent surgical treatment; the overall resection rate was 59.2% (71/120), and the R0 resection rate was 40.8% (49/120). Compared with non-R0 treatment, the patients receiving an R0 resection had smaller size tumor (P<0.01), cystadenocarcinoma (P<0.01), less lymph node metastasis (P<0.01), less peri-pancreatic organ involvement (P<0.01) and earlier stage disease (P<0.01). The overall 1-, 3- and 5-year survival rates for pancreatic body and tail cancer patients were 12.7% (25/197), 7.6% (15/197) and 2.5% (5/197), respectively, and ductal adenocarcinoma patients had worse survival rates [15.0% (9/60), 6.7% (4/60) and 1.7% (1/60), respectively] than cystadenocarcinoma patients [53.8% (21/39), 28.2% (11/39) and 10.3% (4/39)] (P<0.01). Moreover, the 1-, 3- and 5-year overall survival rates in patients with R0 resection were 55.3% (26/47), 31.9% (15/47) and 10.6% (5/47), respectively, significantly better than those in patients with palliative resection [9.5% (2/21), 0 and 0] and in patients with bypass or laparotomy [1.2% (1/81), 0 and 0] (P<0.01).

CONCLUSION

Early diagnosis is crucial for increasing the radical resection rate, and radical resection plays an important role in improving survival for pancreatic body and tail cancer patients.

摘要

目的

分析影响胰体尾恶性肿瘤根治性(R0)切除率和手术效果的因素。

方法

回顾性分析 214 例胰体尾癌患者的临床和手术资料及随访结果。

结果

120/214 例胰体尾癌患者接受了手术治疗;总体切除率为 59.2%(71/120),R0 切除率为 40.8%(49/120)。与非 R0 治疗相比,接受 R0 切除的患者肿瘤体积较小(P<0.01)、囊腺癌(P<0.01)、淋巴结转移较少(P<0.01)、胰周器官受累较少(P<0.01)、疾病分期较早(P<0.01)。胰体尾癌患者的总体 1、3、5 年生存率分别为 12.7%(25/197)、7.6%(15/197)和 2.5%(5/197),其中导管腺癌患者的生存率较差[15.0%(9/60)、6.7%(4/60)和 1.7%(1/60)],而囊腺癌患者的生存率较好[53.8%(21/39)、28.2%(11/39)和 10.3%(4/39)](P<0.01)。此外,R0 切除患者的 1、3、5 年总生存率分别为 55.3%(26/47)、31.9%(15/47)和 10.6%(5/47),明显优于姑息性切除患者[9.5%(2/21)、0 和 0]和旁路或剖腹探查患者[1.2%(1/81)、0 和 0](P<0.01)。

结论

早期诊断对提高根治性切除率至关重要,根治性切除对改善胰体尾癌患者的生存至关重要。