Loveček M, Skalický P, Klos D, Neoral Č, Ehrmann J, Zapletalová J, Švébišová H, Yogeswara T, Ghothim M, Vrba R, Havlík R
Rozhl Chir. 2015 Nov;94(11):470-6.
The purpose was to identify 5-year survivors among a group of radically resected patients with pancreatic cancer and analyse the characteristics and factors associated with their 5-year survival. Single tertiary centre experience.
A prospectively maintained database of 155 pancreatic resections from January 2006 to June 2010 was scanned to identify patients after curative radical resections for pancreatic ductal adenocarcinoma. The clinical and pathological data was analysed retrospectively. The outcomes of the PDAC group were evaluated using Kaplan-Meier analysis (survival) with the Log-rank test and Cox regression analysis (evaluation of prognostic factors). Characteristics of the survivors were discussed. Significance level of 0.05 was used. Those factors were used as independent variables for Cox regression analysis whose significant effect on survival was shown based on Kaplan-Meier analysis.
Among 155 patients undergoing a curative pancreatic resection, 73 had a pancreatic ductal adenocarcinoma. Fifteen patients (20.5%) after radical surgery survived over 5 years, 13 of whom are still alive. In the group of the survivors, the mean overall survival was 77.1 months (60110) and the median survival was 74 months. The mean relapse-free interval in the group of the survivors was 63.3 months (14110) with the median of 65 months. Factors associated with a longer survival included the absence of lymph node infiltration (p=0.031), uncomplicated postoperative course (p=0.025), absence of vascular invasion (p=0.017), no blood transfusions (p=0.015) and the use of postoperative therapy - predominantly chemotherapy (p=0.009). Significant independent predictors of survival included vascular invasion HR=2.239 (95%CI: 1.0934.590; p=0.028), postoperative chemotherapy HR=2.587 (95%CI: 1.3015.145; p=0.007) and blood transfusion HR=2.080 (95%CI: 1.0274.212; p=0.042). The risk of death was increased 2.2 times in patients with vascular invasion, 2.1 times in patients with transfusions, and finally 2.6 times in those with no chemotherapy.
Factors associated with an improved overall survival included: the absence of lymph node infiltration, an uncomplicated postoperative course, absence of vascular invasion, no need of blood transfusions, and finally the use of postoperative chemotherapy. Vascular invasion, use of blood transfusions and postoperative adjuvant chemotherapy were significant independent prognostic factors of survival.
目的是在一组接受根治性切除的胰腺癌患者中识别出5年生存者，并分析与他们5年生存相关的特征和因素。单中心三级医院经验。
对2006年1月至2010年6月期间前瞻性维护的155例胰腺切除术数据库进行筛查，以识别接受胰腺导管腺癌根治性切除术后的患者。对临床和病理数据进行回顾性分析。使用Kaplan-Meier分析（生存）和对数秩检验以及Cox回归分析（评估预后因素）来评估胰腺导管腺癌组的结果。讨论了生存者的特征。使用0.05的显著性水平。那些基于Kaplan-Meier分析显示对生存有显著影响的因素被用作Cox回归分析的自变量。
在155例接受根治性胰腺切除术的患者中，73例患有胰腺导管腺癌。15例（20.5%）根治性手术后的患者存活超过5年，其中13例仍然存活。在生存者组中，平均总生存期为77.1个月（60至110），中位生存期为74个月。生存者组的平均无复发生存期为63.3个月（14至110），中位数为65个月。与较长生存期相关的因素包括无淋巴结浸润（p = 0.031）、术后病程无并发症（p = 0.025）、无血管侵犯（p = 0.017）、未输血（p = 0.015）以及使用术后治疗——主要是化疗（p = 0.009）。生存的显著独立预测因素包括血管侵犯HR = 2.239（95%CI：1.093至4.590；p = 0.028）、术后化疗HR = 2.587（95%CI：1.301至5.145；p = 0.007）和输血HR = 2.080（95%CI：1.027至4.212；p = 0.042）。血管侵犯患者的死亡风险增加2.
