淋巴结比率、神经周围侵犯和R1切除作为胰腺腺癌独立的预后因素：一项回顾性队列研究

Lymph Node Ratio, Perineural Invasion and R1 Resection as Independent Prognostic Factors in Pancreatic Adenocarcinoma: A Retrospective Cohort Study.

作者信息

Di Martino Marcello, Ielpo Benedetto, de Nova Jose Luis Muñoz, Muñoz Enrique Alday, Santamaria Cristina, Diago Victoria, Martín-Pérez Elena

机构信息

Department of Surgery, HPB Unit, University Hospital La Princesa, Madrid, Spain.

Department of Surgery, HPB Unit, University Hospital Leon, Leon, Spain.

出版信息

Surg Technol Int. 2020 May 28;36:82-88.

PMID:32190897

Abstract

INTRODUCTION

The prognosis of pancreatic ductal adenocarcinoma has been associated with several factors. The aim of the present study was to correlate tumor-related factors and pathological findings with disease-free survival (DFS) and overall survival (OS) in patients undergoing pancreaticoduodenectomy.

MATERIAL AND METHODS

From a prospectively maintained database, we reviewed 89 pancreatic ductal adenocarcinomas in patients who underwent pancreaticoduodenectomy from 2010 to 2014. The impact of histopathologic or tumor-related data, including a lymph node ratio greater than 15% (LNR15), on survival was analyzed.

RESULTS

Univariate analysis of DFS and OS showed that vascular resection, pT, pN, LNR15, microvascular, lymphatic, and perineural invasion, and R1 resection influenced survival. Only LNR15, perineural invasion and R1 resection were independent predictors for both DFS (HR 6.39, p = 0.011; HR 8.53, p = 0.003; HR 9.68, p = 0.002, respectively) and OS (HR 4.21, p = 0.039; HR 5.41, p = 0.020; HR 4.41, p = 0.036, respectively).

CONCLUSIONS

This study demonstrates that LNR15, perineural invasion and R1 resection are independently associated with DFS and OS.

摘要

引言

胰腺导管腺癌的预后与多种因素相关。本研究的目的是将肿瘤相关因素和病理结果与接受胰十二指肠切除术患者的无病生存期（DFS）和总生存期（OS）进行关联分析。

材料与方法

我们从一个前瞻性维护的数据库中，回顾了2010年至2014年期间接受胰十二指肠切除术的89例胰腺导管腺癌患者。分析了组织病理学或肿瘤相关数据，包括淋巴结比率大于15%（LNR15）对生存的影响。

结果

DFS和OS的单因素分析显示，血管切除、pT、pN、LNR15、微血管、淋巴管和神经周围侵犯以及R1切除影响生存。仅LNR15、神经周围侵犯和R1切除是DFS（HR 6.39，p = 0.011；HR 8.53，p = 0.003；HR 9.68，p = 0.002）和OS（HR 4.21，p = 0.039；HR 5.41，p = 0.020；HR 4.41，p = 0.036）的独立预测因素。