Aoyama Toru, Murakawa Masaaki, Katayama Yusuke, Shiozawa Manabu, Ueno Makoto, Morimoto Manabu, Yoshikawa Takaki, Rino Yasushi, Masuda Munetaka, Morinaga Soichiro
Hepatogastroenterology. 2015 Mar-Apr;62(138):472-7.
BACKGROUND/AIMS: The objective of this retrospective study was to clarify prognostic factors in pancreatic cancer patients undergoing curative resection followed by adjuvant chemotherapy with gemcitabine or S-1.
Both overall survival (OS) and recurrence-free survival (RFS) were examined in 122 pancreatic cancer patients who underwent curative surgery and received adjuvant gemcitabine or S-1 after surgery between 2005 and 2014.
When the length of OS was evaluated according to the log-rank test, significant differences were observed in lymphatic invasion and the T status. Univariate and multivariate Cox's proportional hazard analyses demonstrated that lymphatic invasion was the only significant independent prognostic factor for both OS and RFS. The 5-year OS was 30.1% in the lymphatic invasion-negative group and 12.1% in the lymphatic invasion-positive group (p < 0.001). Moreover, the 5-year RFS was 20.5% in the lymphatic invasion-negative group and 10.4% in the lymphatic invasion- positive group (p = 0.006).
Lymphatic invasion is the most important prognostic factor for OS and RFS in patients with pancreatic cancer who undergo curative resection followed by adjuvant chemotherapy. The present results suggest that adjuvant chemotherapy is not sufficient, especially in patients with risk factors. Such patients should be evaluated as a target group for clinical trials of novel treatments.
背景/目的：本回顾性研究的目的是明确接受根治性切除并接受吉西他滨或S-1辅助化疗的胰腺癌患者的预后因素。
对2005年至2014年间接受根治性手术并在术后接受吉西他滨或S-1辅助化疗的122例胰腺癌患者的总生存期（OS）和无复发生存期（RFS）进行了研究。
根据对数秩检验评估OS时长时，在淋巴侵犯和T分期方面观察到显著差异。单因素和多因素Cox比例风险分析表明，淋巴侵犯是OS和RFS唯一显著的独立预后因素。淋巴侵犯阴性组的5年OS为30.1%，淋巴侵犯阳性组为12.1%（p<0.001）。此外，淋巴侵犯阴性组的5年RFS为20.5%，淋巴侵犯阳性组为10.4%（p = 0.006）。
对于接受根治性切除并辅助化疗的胰腺癌患者，淋巴侵犯是OS和RFS最重要的预后因素。目前的结果表明，辅助化疗并不充分，尤其是对于有危险因素的患者。此类患者应作为新治疗方法临床试验的目标人群进行评估。
