Sperti C, Pasquali C, Piccoli A, Pedrazzoli S
Department of Surgery, University of Padova, Padua, Italy.
Br J Surg. 1996 May;83(5):625-31. doi: 10.1002/bjs.1800830512.
A retrospective study was performed of 113 patients who underwent surgical resection of carcinoma of the pancreas from 1970 to 1992. The postoperative mortality rate was 15 per cent (5 per cent in the last 11 years). The actuarial 5-year survival rate was 12 per cent. Survival was significantly influenced by age (P = 0.03), vascular resection (P = 0.02), radicality of operation (P = 0.01), number of transfused blood units (P = 0.01), tumour differentiation (P = 0.002), lymph node status (P = 0.001), perineural invasion (P = 0.01), tumour size (P = 0.008), preoperative diabetes (P = 0.001) and stage (P = 0.0001). Multivariate analysis showed that stage, diabetes, age and grade were independent predictors of long-term survival. The type of pancreatic resection (Whipple, subtotal, total or distal pancreatectomy) did not influence prognosis. The 5-year survival rate was 14 per cent in the period 1970-1981 and 11 per cent in the period 1982-1992, with no statistical difference. These results suggest that patient characteristics and tumour findings rather than operative procedures affect long-term survival after resection for pancreatic carcinoma.
对1970年至1992年间接受胰腺癌手术切除的113例患者进行了一项回顾性研究。术后死亡率为15%（最近11年为5%）。精算5年生存率为12%。生存受到年龄（P = 0.03）、血管切除（P = 0.02）、手术根治性（P = 0.01）、输血量（P = 0.01）、肿瘤分化（P = 0.002）、淋巴结状态（P = 0.001）、神经周围侵犯（P = 0.01）、肿瘤大小（P = 0.008）、术前糖尿病（P = 0.001）和分期（P = 0.0001）的显著影响。多变量分析显示，分期、糖尿病、年龄和分级是长期生存的独立预测因素。胰腺切除术的类型（惠普尔手术、次全切除术、全切除术或远端胰腺切除术）不影响预后。1970 - 1981年期间5年生存率为14%，1982 - 1992年期间为11%，无统计学差异。这些结果表明，患者特征和肿瘤表现而非手术操作影响胰腺癌切除术后的长期生存。
