Ikuta Yoshiaki, Takamori Hiroshi, Sakamoto Yasuo, Hashimoto Daisuke, Chikamoto Akira, Kuroki Hideyuki, Sakata Kazuya, Sakamoto Keita, Hayashi Hiromitsu, Imai Katsunori, Nitta Hidetoshi, Hirota Masahiko, Kanemitsu Keiichiro, Beppu Toru, Baba Hideo
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
Int J Clin Oncol. 2014 Aug;19(4):629-33. doi: 10.1007/s10147-013-0613-y. Epub 2013 Sep 3.
Patients with unresectable pancreatic and biliary cancers sometimes need decompression due to obstruction of the gastrointestinal tract and/or biliary tract. The aim of this study was to determine the prognostic factors associated with an indication for palliative bypass surgery in patients with unresectable pancreatic and biliary cancers.
Between April 2005 and September 2011, 37 patients with unresectable pancreatic and biliary cancers underwent palliative bypass surgery. Prognostic factors were searched for among clinical characteristics, operation-related factors, and tumor-related factors using a prospective database.
The median survival time (MST) of these patients was 4.6 months, with a 6-month survival rate of 40.5 %. A multivariate Cox proportional hazards regression analysis revealed that mGPS >2 was the only independent prognostic factor for bypass surgery. Patients with an mGPS of 2 had an MST of 1.7 months, and they had a significantly worse prognosis than mGPS 0-1 patients with an MST of 6.3 months.
The mGPS is useful for predicting survival after surgical decompression due to gastrointestinal obstruction in patients with unresectable pancreatic and biliary cancers. Patients with a poor mGPS may not be indicated for palliative bypass surgery.
无法切除的胰腺癌和胆管癌患者有时因胃肠道和/或胆道梗阻而需要减压。本研究的目的是确定与无法切除的胰腺癌和胆管癌患者姑息性搭桥手术指征相关的预后因素。
2005年4月至2011年9月期间，37例无法切除的胰腺癌和胆管癌患者接受了姑息性搭桥手术。使用前瞻性数据库在临床特征、手术相关因素和肿瘤相关因素中寻找预后因素。
这些患者的中位生存时间（MST）为4.6个月，6个月生存率为40.5%。多因素Cox比例风险回归分析显示，改良格拉斯哥预后评分（mGPS）>2是搭桥手术唯一的独立预后因素。mGPS为2的患者MST为1.7个月，其预后明显差于mGPS为0 - 1且MST为6.3个月的患者。
mGPS有助于预测无法切除的胰腺癌和胆管癌患者因胃肠道梗阻进行手术减压后的生存情况。mGPS较差的患者可能不适合进行姑息性搭桥手术。
