Gao Chun-Tao, Li Hui-Kai, Li Qiang
Department of Pancreatic Surgery, Tianjin Key Laboratory of Cancer Prevention and Therapy, Cancer Hospital, Tianjin Medical University, Tianjin 300060, China.
Zhonghua Zhong Liu Za Zhi. 2009 Jul;31(7):554-7.
The aim of this cohort study was to investigate the clinical outcome and prognostic factors in patients after resection for ductal adenocarcinoma of the pancreatic head.
patients with pancreatic head cancer undergoing curative resection (R0) between 1997 and 2002 were included in this study. Univariate and multivariate analyses were performed to examine factors affecting clinical outcome and recurrence of the cancer.
Surgical procedures consisted of 58 (43.3%) extended pancreaticoduodenectomies (EPD), 47 (35.1%) pancreaticoduodenectomies (PD) and 29 (21.6%) pylorus-preserving pancreaticoduodenectomies (PPPD). The results showed that 81.3% (109/134) of patients had a recurrence during the study period, mainly retroperitoneal combined with distant metastasis (53.7%). The median postoperative survival time was 24.7 months. The 1-, 3- and 5-year overall survival rates for the study population were 67.1%, 38.5% and 17.6%, respectively. Univariate analysis showed that preoperative abdominal and/or back pain, tumor size > 2 cm, lymph node involvement and vascular invasion, and CA19-9 level were all significant predictors for poor survival. Multivariate analysis also showed that preoperative abdominal and/or back pain, tumor size > 2 cm, lymph node involvement and vascular invasion were all significant predictors for poor survival.
Our results suggest that preoperative abdominal and/or back pain, tumor size > 2 cm, lymph node involvement and vascular invasion are significant predictors for poor survival in patients with pancreatic head cancer.
本队列研究旨在调查胰头导管腺癌切除术后患者的临床结局及预后因素。
本研究纳入了1997年至2002年间接受根治性切除（R0）的胰头癌患者。进行单因素和多因素分析以检查影响癌症临床结局和复发的因素。
手术方式包括58例（43.3%）扩大胰十二指肠切除术（EPD）、47例（35.1%）胰十二指肠切除术（PD）和29例（21.6%）保留幽门的胰十二指肠切除术（PPPD）。结果显示，81.3%（109/134）的患者在研究期间出现复发，主要为腹膜后联合远处转移（53.7%）。术后中位生存时间为24.7个月。研究人群的1年、3年和5年总生存率分别为67.1%、38.5%和17.6%。单因素分析显示，术前腹部和/或背部疼痛、肿瘤大小>2 cm、淋巴结受累和血管侵犯以及CA19-9水平均是生存不良的显著预测因素。多因素分析还显示，术前腹部和/或背部疼痛、肿瘤大小>2 cm、淋巴结受累和血管侵犯均是生存不良的显著预测因素。
我们的结果表明，术前腹部和/或背部疼痛、肿瘤大小>2 cm、淋巴结受累和血管侵犯是胰头癌患者生存不良的显著预测因素。
