不可切除的胰尾癌中的脾门受累及左侧门静脉高压
Splenic Hilar Involvement and Sinistral Portal Hypertension in Unresectable Pancreatic Tail Cancer.
作者信息
Okamoto Takeshi, Takeda Tsuyoshi, Mie Takafumi, Hirai Tatsuki, Ishitsuka Takahiro, Yamada Manabu, Nakagawa Hiroki, Furukawa Takaaki, Kasuga Akiyoshi, Sasaki Takashi, Ozaka Masato, Sasahira Naoki
机构信息
Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan.
出版信息
Cancers (Basel). 2023 Dec 15;15(24):5862. doi: 10.3390/cancers15245862.
BACKGROUND
Pancreatic tail cancer (PTC) frequently displays splenic hilar involvement (SHI), but its impact on clinical outcomes remains unclear. We investigated the clinical impact of SHI in patients with unresectable PTC.
METHODS
We retrospectively reviewed all patients with unresectable PTC who received first-line therapy at our institution from 2016 to 2020.
RESULTS
Of the 111 included patients, 48 had SHI at diagnosis. SHI was significantly associated with younger age, liver metastasis, peritoneal dissemination, larger tumor size, modified Glasgow prognostic score of 1 or more, splenic artery involvement, gastric varices, and splenomegaly. Shorter median overall survival (OS; 9.3 vs. 11.6 months, = 0.003) and progression-free survival (PFS; 4.3 vs. 6.3 months, = 0.013) were observed in SHI patients. Poor performance status of 1 or 2, tumor size > 50 mm, hepatic metastasis, mGPS of 1 or 2, and SHI (hazard ratio: 1.65, 95% confidence interval: 1.08-2.52, = 0.020) were independent predictors of shorter OS. Splenic artery pseudoaneurysm rupture and variceal rupture were rare and only observed in cases with SHI.
CONCLUSIONS
Splenic hilar involvement is associated with worse outcomes in pancreatic tail cancer.
背景
胰尾癌（PTC）常表现为脾门受累（SHI），但其对临床结局的影响尚不清楚。我们研究了SHI对不可切除PTC患者的临床影响。
方法
我们回顾性分析了2016年至2020年在我院接受一线治疗的所有不可切除PTC患者。
结果
在纳入的111例患者中，48例在诊断时存在SHI。SHI与年龄较小、肝转移、腹膜播散、肿瘤较大、改良格拉斯哥预后评分≥1、脾动脉受累、胃静脉曲张和脾肿大显著相关。SHI患者的中位总生存期（OS；9.3个月对11.6个月，P = 0.003）和无进展生存期（PFS；4.3个月对6.3个月，P = 0.013）较短。体能状态差（1或2级）、肿瘤大小>50 mm、肝转移、mGPS为1或2级以及SHI（风险比：1.65，95%置信区间：1.08 - 2.52，P = 0.020）是较短OS的独立预测因素。脾动脉假性动脉瘤破裂和静脉曲张破裂很少见，仅在SHI病例中观察到。
结论
脾门受累与胰尾癌的不良结局相关。
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