壶腹腺癌胰十二指肠切除术后的管理与结局

Management and outcomes following pancreaticoduodenectomy for ampullary adenocarcinoma.

作者信息

Chavez M T, Sharpe J P, O'Brien T, Patton K T, Portnoy D C, VanderWalde N A, Deneve J L, Shibata D, Behrman S W, Dickson P V

机构信息

Department of Surgery, Division of Surgical Oncology, University of Tennessee Health Science Center, Memphis, TN, USA.

Memphis Pathology Group, Memphis, TN, USA.

出版信息

Am J Surg. 2017 Nov;214(5):856-861. doi: 10.1016/j.amjsurg.2017.01.029. Epub 2017 Jan 30.

DOI:10.1016/j.amjsurg.2017.01.029

PMID:28285709

Abstract

INTRODUCTION

The purpose of this study was to evaluate outcomes following pancreaticoduodenectomy(PD) for ampullary adenocarcinoma(AAC).

METHODS

We evaluated patients having undergone PD for AAC and the impact of clinical/histopathologic factors and adjuvant therapy(AT) on survival.

RESULTS

52 patients underwent potentially curative PD. Perineural and lymphovascular invasion were associated with decreased survival. There was no difference in survival between patients treated with PD vs. PD+AT, however, AT was more often administered to patients with N1 vs. N0 and stage II/III vs. I disease. Among patients receiving AT, we observed a trend towards improved survival when radiation was included. Recurrence occurred in 7/18(39%) stage I patients, only 2(7%) of which received AT.

CONCLUSION

AT did not improve survival, however was more commonly administered in advanced disease. Stage I patients had high recurrence rates but rarely received AT. Prospective evaluation of appropriate AT regimens and use in early stage patients should be considered.

摘要

引言

本研究的目的是评估壶腹腺癌（AAC）行胰十二指肠切除术（PD）后的疗效。

方法

我们评估了接受PD治疗的AAC患者，以及临床/组织病理学因素和辅助治疗（AT）对生存的影响。

结果

52例患者接受了可能治愈性的PD。神经周围和淋巴管侵犯与生存率降低相关。接受PD与PD+AT治疗的患者生存率无差异，然而，N1期与N0期以及II/III期与I期疾病患者中，AT更常用于前者。在接受AT的患者中，我们观察到包含放疗时生存有改善的趋势。18例I期患者中有7例（39%）复发，其中仅2例（7%）接受了AT。