He C B, Wang J, Mao Y Z, Lao X M, Li S P
Department of Pancreatobiliary Surgery,State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine,Sun Yat-sen University Cancer Center,Guangzhou 510060,China.
Zhonghua Wai Ke Za Zhi. 2022 Oct 1;60(10):948-954. doi: 10.3760/cma.j.cn112139-20220415-00168.
To compare the short-term and long-term prognosis of irreversible electroporation(IRE) and conversional resection for locally advanced pancreatic cancer(LAPC). The clinical and pathological data of 98 LAPC patients who underwent IRE or conversional resection at the Department of Pancreatobiliary Surgery,Sun Yat-sen University Cancer Center from August 2015 to December 2020 were retrospectively collected and analyzed.The study comprised of 53 males and 45 females, with age((IQR)) of 57.5(13.5)years old(range:20 to 87 years old). Fifty-three patients received IRE treatment(IRE group) and 45 patients received surgical resection(resection group). The differences of clinical and pathological data between both groups were not significant(all <0.05). The Mann-Whitney test was used for quantitative data and the χ test was used for categorical data.Survival was analyzed using Kaplan-Meier method and compared using Log-rank test. The operation time and intraoperative blood loss were 5.0(2.4)hours and 50(100) ml in the IRE group,respectively,which were significantly less than those of resection group(7.0(3.3)hours and 400(200)ml,both <0.05).The hospital stay and hospitalization cost were 9.0(3.0)days and 79 154 (83 738) yuan in the IRE group,respectively,which were also significantly less than those in the resection group(16.0(8.5)days and 109 557(37 795)yuan,both <0.05).The complication rate of IRE group was significantly lower than that of the resection group(18.8% 55.6%,χ=14.270,<0.01).The median overall survival(OS) time of IRE group was 28.9 months(95%:23.2 to 34.6 months),with the 1-,2-,and 3-year OS rates of 91.6%,61.7%,and 24.6%,respectively.The median survival of OS of resection group was 27.1 months(95%:20.9 to 33.3 months),with the 1-,2-,and 3-year OS rates of 81.8%,53.9%,and 30.3%,respectively.There was no significant difference in OS between the two groups(χ=0.900,=0.760).The median progression free survival(PFS) time of IRE group was 18.0 months(95%:14.7 to 21.3 months),with the 1-,2-,and 3-year PFS rates of 68.3%,29.7%,and 9.9%,respectively.The median survival of PFS of resection group was 11.1 months(95%:6.1 to 16.2 months),with the 1-,2-,and 3-year PFS rates of 45.2%,21.9%,and 14.6%,respectively.There was no significant difference in PFS between the two groups(χ=1.850,=0.170). IRE can achieve similar survival for LAPC and may has less complications compared to those with conversion resection.
比较不可逆电穿孔（IRE）与传统切除术治疗局部晚期胰腺癌（LAPC）的短期和长期预后。回顾性收集并分析了2015年8月至2020年12月在中山大学肿瘤防治中心胰胆外科接受IRE或传统切除术的98例LAPC患者的临床和病理资料。该研究包括53例男性和45例女性，年龄（四分位间距）为57.5（13.5）岁（范围：20至87岁）。53例患者接受IRE治疗（IRE组），45例患者接受手术切除（切除组）。两组临床和病理资料差异无统计学意义（均P<0.05）。定量资料采用Mann-Whitney检验，分类资料采用χ²检验。采用Kaplan-Meier法分析生存率，Log-rank检验进行比较。IRE组手术时间和术中出血量分别为5.0（2.4）小时和50（100）ml，明显少于切除组（7.0（3.3）小时和400（200）ml，均P<0.05）。IRE组住院时间和住院费用分别为9.0（3.0）天和79 154（83 738）元，也明显少于切除组（16.0（8.5）天和109 557（37 795）元，均P<0.05）。IRE组并发症发生率明显低于切除组（18.8%比55.6%，χ²=14.270，P<0.01）。IRE组中位总生存（OS）时间为28.9个月（95%CI：23.2至34.6个月），1年、2年和3年OS率分别为91.6%、61.7%和24.6%。切除组OS中位生存时间为27.1个月（95%CI：20.9至33.3个月），1年、2年和3年OS率分别为81.8%、53.9%和30.3%。两组OS差异无统计学意义（χ²=0.900，P=0.760）。IRE组中位无进展生存（PFS）时间为18.0个月（95%CI：14.7至21.3个月），1年、2年和3年PFS率分别为6
