疑似静脉受累的胰腺腺癌切除术的结果：单中心经验
Outcomes of resections for pancreatic adenocarcinoma with suspected venous involvement: a single center experience.
作者信息
Michalski Christoph W, Kong Bo, Jäger Carsten, Kloe Silke, Beier Barbara, Braren Rickmer, Esposito Irene, Erkan Mert, Friess Helmut, Kleeff Jorg
机构信息
Department of Surgery, Technische Universität München, Ismaningerstrasse 22, 81675, Munich, Germany.
Current address: Department of Surgery, University of Heidelberg, Heidelberg, Germany.
出版信息
BMC Surg. 2015 Aug 22;15:100. doi: 10.1186/s12893-015-0086-1.
BACKGROUND
Pancreatic ductal adenocarcinoma (PDAC) patients frequently present with borderline resectable disease, which can be due to invasion of the portal/superior mesenteric vein (PV/SMV). Here, we analyzed this group of patients, with emphasis on short and long-term outcomes.
METHODS
156 patients who underwent a resection for PDAC were included in the analysis and sub-stratified into a cohort of patients with PV/SMV resection (n = 54) versus those with standard surgeries (n = 102).
RESULTS
While venous resections could be performed safely, there was a trend towards shorter median survival in the PV/SMV resection group (22.7 vs. 15.8 months, p = 0.157). These tumors were significantly larger (3.5 vs. 4.3 cm; p = 0.026) and margin-positivity was more frequent (30.4% vs. 44.4%, p = 0.046).
CONCLUSION
Venous resection was associated with a higher rate of margin positivity and a trend towards shorter survival. However, compared to non-surgical treatment, resection offers the best chance for long term survival.
背景
胰腺导管腺癌（PDAC）患者常表现为可切除边缘的疾病，这可能是由于门静脉/肠系膜上静脉（PV/SMV）受侵所致。在此，我们分析了这组患者，重点关注短期和长期预后。
方法
156例行PDAC切除术的患者纳入分析，并分为PV/SMV切除术组（n = 54）和标准手术组（n = 102）。
结果
虽然静脉切除术可安全进行，但PV/SMV切除术组的中位生存期有缩短趋势（22.7个月对15.8个月，p = 0.157）。这些肿瘤明显更大（3.5 cm对4.3 cm；p = 0.026），切缘阳性更常见（30.4%对44.4%，p = 0.046）。
结论
静脉切除术与切缘阳性率较高及生存期缩短趋势相关。然而，与非手术治疗相比，手术切除为长期生存提供了最佳机会。
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