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接受根治性切除术后辅助吉西他滨或S-1化疗的胰腺癌患者腹膜细胞学检查的临床意义

Clinical implication of peritoneal cytology in the pancreatic cancer patients who underwent curative resection followed by adjuvant gemcitabine or S-1 chemotherapy.

作者信息

Aoyama Toru, Katayama Yusuke, Murakawa Masaaki, Shiozawa Manabu, Morimoto Manabu, Yamamoto Naoto, Yoshikawa Takaki, Rino Yasushi, Masuda Munetaka, Morinaga Soichiro

出版信息

Hepatogastroenterology. 2015 Jan-Feb;62(137):200-6.

Abstract

BACKGROUND/AIMS: The clinical implications of peritoneal lavage cytology (CY) status in the patients who received curative resection and adjuvant chemotherapy have not been established.

METHODOLOGY

We retrospectively analyzed clinical data from 143 consecutive patients who underwent macroscopically curative resection and received adjuvant gemcitabine or S-1 chemotherapy for pancreatic cancer from 2005 to 2014 in our institution. Correlations between CY status and survival and clinicopathological features were investigated.

RESULTS

Of the 143 patients, 21 patients were peritoneal washing cytology positive (CY+) (14.7%). Although significant difference was observed in the tumor size, no other correlation between cytology status and clinicopathological parameter existed. The recurrence free survival (RFS) rates at 3 and 5 years after surgery were 5.1% and 0% in CY+ patients, respectively, and were 21.5% and 16.1% in peritoneal washing cytology negative (CY-) patients, respectively, which were significantly different (p=0.001). The OS rates at 3 and 5 years after surgery were 17.1% and 8.6% in CY+ patients, respectively, and were 26.1% and 16.1% in CY- patients, respectively, which were trend to worse in the CY+ patients (p=0.254).

CONCLUSION

The patients with CY+ are likely to experience recurrence, even after they received curative resection and adjuvant Gemcitabine or S-1 adjuvant chemotherapy.

摘要

背景/目的:对于接受根治性切除及辅助化疗的患者,腹腔灌洗细胞学(CY)状态的临床意义尚未明确。

方法

我们回顾性分析了2005年至2014年在我院连续接受胰腺癌宏观根治性切除并接受吉西他滨或S-1辅助化疗的143例患者的临床资料。研究CY状态与生存率及临床病理特征之间的相关性。

结果

143例患者中,21例腹腔冲洗细胞学阳性(CY+)(14.7%)。虽然在肿瘤大小方面观察到显著差异,但细胞学状态与临床病理参数之间不存在其他相关性。CY+患者术后3年和5年的无复发生存率(RFS)分别为5.1%和0%,腹腔冲洗细胞学阴性(CY-)患者分别为21.5%和16.1%,差异有统计学意义(p=0.001)。CY+患者术后3年和5年的总生存率(OS)分别为17.1%和8.6%,CY-患者分别为26.1%和16.1%,CY+患者有生存趋势更差(p=0.254)。

结论

CY+患者即使接受了根治性切除及吉西他滨或S-1辅助化疗,仍可能复发。

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