Lee Mirang, Kwon Wooil, Kim Hongbeom, Byun Yoonhyeong, Han Youngmin, Kang Jae Seung, Choi Yoo Jin, Jang Jin-Young
Department of surgery, Seoul National University Hospital, Seoul 03080, Korea.
Cancers (Basel). 2020 Jul 24;12(8):2036. doi: 10.3390/cancers12082036.
Identification of prognostic factors is important to improve treatment outcomes in pancreatic cancer. This study aimed to investigate the effect of the location of pancreatic cancer on survival and to determine whether it was a significant prognostic factor. Altogether, 2483 patients diagnosed with pancreatic cancer were examined. Comparative analysis of clinicopathologic characteristics, survival analysis, and multivariate analysis were performed. Cancers of the pancreatic head or the uncinate process were present in 49.5% of patients. The head/uncinate cancers had more clinical T1/T2 tumors (59.4% vs. 35.5%, < 0.001) and a significantly higher 5-year survival rate (8.9% vs. 7.3%, < 0.001) than the body/tail cancers. The 5-year survival rate in patients with head/uncinate cancers was significantly lower in the resectable ( = 0.014) and the locally advanced groups ( = 0.007). In patients who underwent resection with curative intent, the 5-year survival rate was lower in the head/uncinate group ( = 0.046). The overall outcome of the head/uncinate cancers was better than the body/tail cancers, due to the high proportion of resectable cases. In patients who underwent curative resection, the head/uncinate cancers had a higher number of T1/T2 tumors, but worse outcomes. In the multivariate analysis, tumor location was not an independent prognostic factor for pancreatic cancer.
识别预后因素对于改善胰腺癌的治疗效果至关重要。本研究旨在探讨胰腺癌位置对生存的影响，并确定其是否为一个重要的预后因素。总共对2483例诊断为胰腺癌的患者进行了检查。进行了临床病理特征的比较分析、生存分析和多因素分析。49.5%的患者患有胰头或钩突癌。与体/尾癌相比，胰头/钩突癌有更多临床T1/T2期肿瘤（59.4%对35.5%，<0.001），且5年生存率显著更高（8.9%对7.3%，<0.001）。在可切除组（=0.014）和局部进展组（=0.007）中，胰头/钩突癌患者的5年生存率显著更低。在接受根治性切除的患者中，胰头/钩突组的5年生存率更低（=0.046）。由于可切除病例比例高，胰头/钩突癌的总体预后优于体/尾癌。在接受根治性切除的患者中，胰头/钩突癌有更多T1/T2期肿瘤，但预后更差。在多因素分析中，肿瘤位置不是胰腺癌的独立预后因素。
