Ku Yuan-Hao, Chen Shih-Chin, Shyr Bor-Uei, Lee Rheun-Chuan, Shyr Yi-Ming, Wang Shin-E
aDepartment of Surgery bDepartment of Radiology, Taipei Veterans General Hospital and National Yang Ming University, Taipei, Taiwan.
Medicine (Baltimore). 2017 Jan;96(2):e5640. doi: 10.1097/MD.0000000000005640.
Pancreatic groove cancer is very rare and can be indistinguishable from groove pancreatitis. This study is to clarify the characteristics, clinical features, managements, and survival outcomes of this rare tumor.Brief descriptions were made for each case of pancreatic groove cancer encountered at our institute. Individualized data of pancreatic groove cancer cases described in the literature were extracted and added to our database to expand the study sample size for a more complete analysis.A total of 33 patients with pancreatic groove cancer were included for analysis, including 4 cases from our institute. The median tumor size was 2.7 cm. The most common symptom was nausea or vomiting (89%), followed by jaundice (67%). Duodenal stenosis was noted by endoscopy in 96% of patients. The histopathological examination revealed well differentiated tumor in 43%. Perineural invasion was noted in 90%, and lymphovascular invasion and lymph node involvement in 83%. Overall 1-year survival rate was 93.3%, and 3- or 5-year survival rate was 62.2%, with a median survival of 11.0 months. Survival outcome for the well-differentiated tumors was better than those of the moderate/poorly differentiated ones.Early involvement of duodenum causing vomiting is often the initial presentation, but obstructive jaundice does not always happen until the disease progresses. Tumor differentiation is a prognostic factor for survival outcome. The possibility of pancreatic groove cancer should be carefully excluded before making the diagnosis of groove pancreatitis for any questionable case.
胰腺沟癌非常罕见,可能与沟部胰腺炎难以区分。本研究旨在阐明这种罕见肿瘤的特征、临床特点、治疗方法及生存结果。对我院遇到的每例胰腺沟癌病例进行简要描述。提取文献中描述的胰腺沟癌病例的个体化数据并添加到我们的数据库中,以扩大研究样本量,进行更全面的分析。
共纳入33例胰腺沟癌患者进行分析,其中4例来自我院。肿瘤中位大小为2.7厘米。最常见的症状是恶心或呕吐(89%),其次是黄疸(67%)。96%的患者经内镜检查发现十二指肠狭窄。组织病理学检查显示43%为高分化肿瘤。90%有神经侵犯,83%有脉管侵犯和淋巴结受累。总体1年生存率为93.3%,3年或5年生存率为62.2%,中位生存期为11.0个月。高分化肿瘤的生存结果优于中/低分化肿瘤。
十二指肠早期受累导致呕吐往往是首发表现,但梗阻性黄疸直到疾病进展时才会出现。肿瘤分化是生存结果的一个预后因素。对于任何可疑病例,在诊断沟部胰腺炎之前应仔细排除胰腺沟癌的可能性。