Legaspi A, Brennan M F
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Surgery. 1988 Dec;104(6):1018-23.
Presentation, treatment, and outcome data were analyzed for 33 patients with islet cell carcinoma who were admitted over a 4 1/2-year period to the surgical service at our institution. The patients were stratified into three groups according to primary mode of therapy as follows: (1) aggressive surgical resection (n = 12); (2) bypass with chemotherapy (n = 13); and (3) diagnostic exploratory laparotomy or bypass without any further therapy (n = 8). Of the patients, 67% were initially seen with advanced disease. Overall, 33% of the tumors were functioning, with a predominance of nonfunctioning tumors in the two groups that were not resectable. Chemotherapy was administered on an individual basis, with symptom palliation as the most common indication. The mean follow-up period was 12.7 +/- 13.1 months (range, 0 to 47.2 months), with an overall estimated 3-year survival rate of 76% calculated by life-table analysis, with 56% alive with disease. The estimated 3-year survival rate was 100% for those who underwent resection, with 83% free of disease. Those patients who had a biopsy or bypass and received chemotherapy had a calculated 3-year survival rate of 34% (p = 0.01 vs. resection), and those who underwent bypass and biopsy only had a 3-year survival rate of 58%. Islet cell carcinoma remains a difficult problem, with primary resection the primary therapeutic modality.
对在4年半时间里入住我们机构外科的33例胰岛细胞癌患者的临床表现、治疗及预后数据进行了分析。根据主要治疗方式，将患者分为三组如下：（1）积极手术切除（n = 12）；（2）化疗联合旁路手术（n = 13）；（3）诊断性剖腹探查术或仅行旁路手术而无进一步治疗（n = 8）。67%的患者初诊时即为晚期疾病。总体而言，33%的肿瘤具有功能，在不可切除的两组中无功能肿瘤占主导。化疗根据个体情况进行，最常见的指征是缓解症状。平均随访期为12.7±13.1个月（范围0至47.2个月），通过寿命表分析计算的总体估计3年生存率为76%，其中56%的患者带瘤存活。接受切除手术患者的估计3年生存率为100%，其中83%无疾病。那些接受活检或旁路手术并接受化疗的患者计算出的3年生存率为34%（与切除手术相比，p = 0.01），而仅接受旁路手术和活检的患者3年生存率为58%。胰岛细胞癌仍然是一个难题，主要治疗方式是一期切除。
