Takada T, Yasuda H, Amano H, Yoshida M, Uchida T
First Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
Hepatogastroenterology. 1997 Mar-Apr;44(14):567-73.
BACKGROUND/AIMS: To determine whether aggressive surgery, consisting of a simultaneous pancreatic and partial hepatic resection, for patients with an invasive metastatic ductal adenocarcinoma of the pancreatic head improves the postoperative outcome.
A total of 109 patients with adenocarcinoma of the pancreatic head were divided into two groups. Group 1 consisted of 33 patients with liver metastasis and Group 2 consisted of 76 patients without liver metastasis. Group 1 was further subdivided into 11 patients(Group 1-A) to aggressive surgery, consisting of pancreatoduodenectomy and partial liver resection, and 22 patients to palliative bypass surgery(group 1-B). Group 2 was subdivided into 37 patients to pancreatoduodenectomy(group 2-A), and 39 patients to bypass surgery(group 2-B).
No significant statistical differences were seen in the outcomes between Group 1-A (median survival period: 6 months) and Group 1-B (median survival period: 4 months). Further, all Group 1-A patients died from multiple recurrent liver metastasis within a year. In addition, the outcomes of Group 1-A were significantly poorer than that of 2-A patients(median survival period: 24 months).
Patients who underwent an aggressive simultaneous resection of primary and metastatic hepatic lesion did not exhibit any improvement. However, it is anticipated that these findings will provide insights into developing an effective adjuvant therapy to impede or destroy macroscopic/occult liver metastasis.
背景/目的：确定对于胰头浸润性转移性导管腺癌患者，同时进行胰腺和部分肝脏切除的积极手术是否能改善术后结局。
总共109例胰头腺癌患者被分为两组。第1组由33例有肝转移的患者组成，第2组由76例无肝转移的患者组成。第1组进一步细分为11例行积极手术（包括胰十二指肠切除术和部分肝切除术）的患者（第1 - A组）和22例行姑息性旁路手术的患者（第1 - B组）。第2组细分为37例行胰十二指肠切除术的患者（第2 - A组）和39例行旁路手术的患者（第2 - B组）。
第1 - A组（中位生存期：6个月）和第1 - B组（中位生存期：4个月）之间的结局无显著统计学差异。此外，所有第1 - A组患者均在1年内死于多处复发性肝转移。另外，第1 - A组的结局明显比第2 - A组患者（中位生存期：24个月）差。
同时对原发性和转移性肝脏病变进行积极切除的患者未表现出任何改善。然而，预计这些发现将为开发有效的辅助治疗以阻止或破坏宏观/隐匿性肝转移提供见解。
