胰十二指肠切除术治疗壶腹周围肿瘤：基于监测、流行病学和最终结果（SEER）数据库的综述文章。
Pancreaticoduodenectomy for periampullary tumours: a review article based on Surveillance, End Results and Epidemiology (SEER) database.
机构信息
College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
出版信息
Clin Transl Oncol. 2018 Sep;20(9):1153-1160. doi: 10.1007/s12094-018-1832-5. Epub 2018 Jan 15.
INTRODUCTION
This study set to examine relative survival of patients with periampullary cancers undergoing pancreaticoduodenectomy (PD).
METHODS
Using the Surveillance, End Results and Epidemiology (SEER) database, this study identified 9877 patients with non-metastatic pancreatic adenocarcinoma who underwent PD between 2004 and 2013.
RESULTS
Ampullary carcinomas have the best survival among periampullary malignancies. Lymph node ratio is a significant prognostic factor, even when stratified by tumour types. Patients receiving adjuvant radiotherapy following PD have superior survival than patients without radiotherapy (median 25 vs 20 months, p < 0.001), particularly ductal adenocarcinoma (HR: 0.74, CI 0.69-0.78; p < 0.001), cholangiocarcinoma (HR: 0.75, CI 0.59-0.97; p = 0.027), and ampullary carcinoma (HR: 0.79, CI 0.64-0.98; p = 0.029) with greatest survival benefit at 1-year postresection.
CONCLUSION
Future studies aiming to further define genetic signatures of individual periampullary cancers would allow a personalised therapeutic approach in improving survival.
简介
本研究旨在探讨接受胰十二指肠切除术（PD）的壶腹周围癌患者的相对生存率。
方法
本研究使用监测、流行病学和最终结果（SEER）数据库，确定了 2004 年至 2013 年间接受 PD 治疗的 9877 例非转移性胰腺腺癌患者。
结果
壶腹癌在壶腹周围恶性肿瘤中具有最佳的生存情况。淋巴结比率是一个重要的预后因素，即使在肿瘤类型分层时也是如此。与未接受放疗的患者相比，接受 PD 后辅助放疗的患者具有更好的生存（中位 25 个月 vs 20 个月，p < 0.001），尤其是导管腺癌（HR：0.74，CI 0.69-0.78；p < 0.001）、胆管癌（HR：0.75，CI 0.59-0.97；p = 0.027）和壶腹癌（HR：0.79，CI 0.64-0.98；p = 0.029），术后 1 年时生存获益最大。
结论
未来旨在进一步确定个体壶腹周围癌遗传特征的研究将允许采用个性化的治疗方法来提高生存率。
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