Klempnauer J, Ridder G J, Bektas H, Pichlmayr R
Klinik für Abdominal- und Transplantationschirurgie, Medizinische Hochschule, Hannover.
Langenbecks Arch Chir. 1995;380(3):133-8. doi: 10.1007/BF00207717.
At Hanover Medical School 466 patients were operated for ductal pancreatic cancer from 1971 to 1993. In 192 cases the pancreatic tumor could be resected, which amounts to a resection rate of 41%. These patients were subjected to uni- und multivariate factorial analysis in order to evaluate factors of significant prognostic value. Extended pancreatic resection because of vascular involvement or invasion of adjacent organs was performed in 40% (n = 77) of the cases. A curative R0 resection was possible in 85% of patients. The operative lethality dropped with time and from 1985 to 1993 was 3.5%. Patient survival at 5 years was 13.4% with a median survival time of 10.9 months. According to the univariate analysis the prognosis deteriorated with increasing tumor size and lymphatic and hematogenic metastases. There was a significant correlation between tumor stage according to the UICC and prognosis. The prognosis after resection was also significantly influenced by the residual tumor state and tumor grading. Extended pancreatic resections, however, had no significant prognostic impact. The multivariate analysis showed that only three factors were of independent significant relevance: residual tumor state, tumor size and tumor grade. The presence or absence of lymphatic and hematogenic metastases had no independent prognostic significance after resection of ductal pancreatic carcinomas.
1971年至1993年间，汉诺威医学院对466例导管腺癌患者进行了手术。其中192例患者的胰腺肿瘤得以切除，切除率为41%。为评估具有显著预后价值的因素，对这些患者进行了单因素和多因素分析。40%（n = 77）的病例因血管受累或邻近器官受侵而进行了扩大胰腺切除术。85%的患者实现了根治性R0切除。手术死亡率随时间下降，1985年至1993年期间为3.5%。患者5年生存率为13.4%，中位生存时间为10.9个月。单因素分析显示，随着肿瘤大小、淋巴和血行转移的增加，预后恶化。根据国际抗癌联盟（UICC）的肿瘤分期与预后之间存在显著相关性。切除术后的预后也受到残留肿瘤状态和肿瘤分级的显著影响。然而，扩大胰腺切除术对预后没有显著影响。多因素分析表明，只有三个因素具有独立的显著相关性：残留肿瘤状态、肿瘤大小和肿瘤分级。导管腺癌切除术后，淋巴和血行转移的有无没有独立的预后意义。
