Chen Jiye, Cai Shouwang, Dong Jiahong
Department of Hepatobiliary Surgery, General Hospital of PLA, Beijing 100853, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2012 Sep;32(9):1242-4.
To investigate the predictors for recurrence of carcinoma ampulla of Vater following pancreatico- duodenectomy.
We reviewed the clinical data of 77 patients with carcinoma of the ampulla of Vater who received surgical intervention with pancreaticoduodenectomy. Independent t-test and χ(2) test were used for statistical comparison, and logistic regression was used for multivariate analysis to investigate the predictors for tumor recurrence following pancreaticoduodenectomy.
The tumor recurred in 30 patients following the surgery. Univariate analysis showed that tumor size (P=0.008), tumor invasion depth (P=0.003), lymph node metastasis status (P=0.039), TNM staging (P=0.027), and grade of cell differentiation (P=0.019) were significant prognostic factors of carcinoma of the ampulla of Vater. Multivariate analysis identified tumor size (P=0.032) and grade of cell differentiation (P=0.027) as independent prognostic factors of the carcinoma.
Distant failure is the predominant recurrence pattern of carcinoma of the ampulla of Vater after curative resections, and tumor size and grade of cell differentiation are the most important factors influencing the outcome of the patients.
探讨胰十二指肠切除术后壶腹癌复发的预测因素。
回顾性分析77例行胰十二指肠切除术的壶腹癌患者的临床资料。采用独立样本t检验和χ²检验进行统计学比较,应用Logistic回归进行多因素分析,以探讨胰十二指肠切除术后肿瘤复发的预测因素。
30例患者术后出现肿瘤复发。单因素分析显示,肿瘤大小(P=0.008)、肿瘤浸润深度(P=0.003)、淋巴结转移状态(P=0.039)、TNM分期(P=0.027)及细胞分化程度(P=0.019)是壶腹癌的重要预后因素。多因素分析确定肿瘤大小(P=0.032)和细胞分化程度(P=0.027)为该癌的独立预后因素。
远处转移是壶腹癌根治性切除术后的主要复发模式,肿瘤大小和细胞分化程度是影响患者预后的最重要因素。