Klempnauer J, Ridder G J, Pichlmayr R
Department of Abdominal and Transplantation Surgery, Hanover Medical School, Germany.
Br J Surg. 1995 Dec;82(12):1686-91. doi: 10.1002/bjs.1800821233.
Resection was performed in 85 patients with ampullary and in 150 with ductal pancreatic head carcinoma. Curative resection was achieved in 98 and 87 per cent respectively. Patient survival at 5 years after exclusion of hospital deaths was 38 versus 16 per cent respectively. The patients were compared retrospectively in a multivariate survival analysis. For patients with pancreatic carcinoma, residual tumour stage, tumour size and grading were independent prognostic factors, but for those with ampullary carcinoma only tumour size was a prognostic factor. Lymph node metastasis impaired prognosis, but this effect was demonstrable for both groups only after univariate analysis. The Union Internacional Contra la Cancrum classification system was not a reliable parameter of prognosis after resection of ampullary carcinoma. Patients with ampullary cancer appear to have a better prognosis intrinsically than those with pancreatic head tumours, and not simply because they present at an earlier stage. The difference in prognosis cannot be explained sufficiently by a differential importance of the various survival variables.
对85例壶腹癌患者和150例胰头导管癌患者进行了切除术。根治性切除率分别为98%和87%。排除医院死亡病例后，5年生存率分别为38%和16%。在多因素生存分析中对患者进行了回顾性比较。对于胰腺癌患者，残余肿瘤分期、肿瘤大小和分级是独立的预后因素，但对于壶腹癌患者，只有肿瘤大小是预后因素。淋巴结转移会影响预后，但只有在单因素分析后，两组的这种影响才明显。国际抗癌联盟分类系统不是壶腹癌切除术后预后的可靠参数。壶腹癌患者似乎本质上比胰头肿瘤患者预后更好，而不仅仅是因为他们就诊时处于更早阶段。各种生存变量的不同重要性不足以解释预后的差异。
