Department of Clinical Sciences Lund, Surgery, Lund University and Skåne University Hospital, Lund, Sweden.
Department of Clinical Sciences Lund, Surgery, Lund University and Skåne University Hospital, Lund, Sweden.
HPB (Oxford). 2021 Jun;23(6):847-853. doi: 10.1016/j.hpb.2020.11.1145. Epub 2020 Dec 15.
Little is known of possible gender differences in treatment of periampullary tumours and outcome after pancreatoduodenectomy (PD), and the aim of this study was therefore to investigate any variances from national multicentre perspective.
Data from the Swedish National Registry for Pancreatic and Periampullary Cancer for all patients diagnosed with a periampullary tumour from 2012 throughout 2017 was collected. The material was analysed in two groups, men and women, for palliative treatment and curative intended resection.
A total of 5677 patients were included, 2906 (51%) men and 2771 (49%) women. Women were older than men, 72 (65-78) years vs. 70 (64-76), p < 0.001. A lesser proportion of women were planned for resection (1131 (41%) vs. 1288 (44%), p = 0.008), but after adjusting for age and tumour location no difference was seen. Postoperative morbidity was equal, but women had significantly better long-term survival than men. The survival was equal for palliative men and women.
No gender bias could be established when analysing treatment for periampullary tumours in Sweden, even though less women were offered surgery. Data suggest that even though women were older they tolerate surgery well and hence offering PD at a higher age for women could be suggested.
关于在胰十二指肠切除术（PD）治疗壶腹周围肿瘤和预后方面是否存在性别差异知之甚少，因此本研究旨在从全国多中心的角度探讨这种差异。
从 2012 年至 2017 年，收集了所有在瑞典国家胰腺和壶腹周围癌症登记处被诊断为壶腹周围肿瘤的患者的数据。将该材料分为两组，男性和女性，分别进行姑息性治疗和治愈性切除分析。
共纳入 5677 例患者，其中男性 2906 例（51%），女性 2771 例（49%）。女性比男性年龄更大，分别为 72 岁（65-78 岁）和 70 岁（64-76 岁），p < 0.001。女性中计划进行切除的比例较低（1131 例[41%] vs. 1288 例[44%]，p = 0.008），但在调整年龄和肿瘤位置后，差异无统计学意义。术后并发症发生率相同，但女性的长期生存明显优于男性。姑息治疗的男性和女性的生存率相同。
在分析瑞典壶腹周围肿瘤的治疗方法时，并未发现性别偏见，尽管女性接受手术的比例较低。数据表明，尽管女性年龄较大，但她们能够很好地耐受手术，因此可以建议为女性提供更高年龄的 PD。
