Kayahara M, Nagakawa T, Ueno K, Ohta T, Kitagawa H, Arakawa H, Yagi H, Tajima H, Miwa K
Second Department of Surgery, School of Medicine, Kanazawa University, Japan.
Hepatogastroenterology. 1998 May-Jun;45(21):827-32.
BACKGROUND/AIMS: Pancreatic resection is the only hope for clinical improvement for patients with carcinoma of the body and tail of the pancreas. However, it is unclear whether palliative pancreatic resection is effective or not for patients with carcinoma of the body and tail of the pancreas.
To determine the appropriate treatment for patients with pancreatic body and tail cancer, we analyzed the records of 74 patients with ductal carcinoma of the body or tail of the pancreas who were treated at Kanazawa University Hospital between 1970 and 1995.
Using a multivariate Cox proportional-hazard model (factors: age, sex, chemotherapy, radiotherapy, hepatic metastasis, peritoneal dissemination, operative procedure), the presence of hepatic metastasis, peritoneal dissemination, and the type of operative procedures (resection or not) were found to be significant prognostic factors. Surgical resection was the most important prognostic factor. The patients with surgical resection had a significantly higher survival rate than those without resection (p < 0.0001). The survival rate of the patients with palliative resections was also significantly higher than that of the patients without resection, except for the patients with advanced liver metastasis (H3). The survival rate of the patients with palliative resections was also higher than that of the patients without resection, even in patients with peritoneal dissemination.
Surgical resection prolongs the average survival for patients with carcinoma of the body and tail of the pancreas, except for the patients with multiple liver metastasis. These data support the role of palliative pancreatectomy in patients with carcinoma of the body and tail pancreas.
背景/目的：胰腺切除术是胰体尾癌患者临床病情改善的唯一希望。然而，姑息性胰腺切除术对胰体尾癌患者是否有效尚不清楚。
为确定胰体尾癌患者的合适治疗方法，我们分析了1970年至1995年间在金泽大学医院接受治疗的74例胰体或胰尾导管癌患者的记录。
使用多变量Cox比例风险模型（因素：年龄、性别、化疗、放疗、肝转移、腹膜播散、手术方式），发现肝转移、腹膜播散的存在以及手术方式（是否切除）是显著的预后因素。手术切除是最重要的预后因素。接受手术切除的患者生存率显著高于未切除的患者（p < 0.0001）。除晚期肝转移（H3）患者外，姑息性切除患者的生存率也显著高于未切除患者。即使在有腹膜播散的患者中，姑息性切除患者的生存率也高于未切除患者。
手术切除可延长胰体尾癌患者的平均生存期，但多发肝转移患者除外。这些数据支持姑息性胰腺切除术在胰体尾癌患者中的作用。
