Nagakawa T, Ohta T, Kayahara M, Mori K, Ueda S, Kobayashi K, Ueno K, Konichi I, Miyazaki I
Department of Health and Science, School of Medicine, Kanazawa University, Ishikawa, Japan.
Hepatogastroenterology. 1998 Sep-Oct;45(23):1865-9.
BACKGROUND/AIMS: This is a study of 43 patients with cancer of the pancreatic head treated by resection in the past 13 years; 8 patients survived for 3 years or more and were compared with 17 who died of cancer within 3 years, in terms of histopathological spread.
Eight patients with cancer of the pancreatic head who survived for 3 years or more after resection were evaluated clinically. They were compared histologically with 17 patients who died of cancer within 3 years.
The long-term survivors had s0 lesion (no frontal invasion of the pancreatic capsule). Lymph node metastasis was absent, or if present, limited to the n1 group. Histological examination showed rpe (positive retroperitoneal invasion) in four of the eight patients (50%). E-ew (-) (no evidence of invasion to the exposed cut surface) was obtained in all patients. They had stage (histological cancer Stage) II or III except for one patient with stage IV.
Based on the results of the evaluation of our patients, the preconditions at present for prolonged survival for patients with cancer of the pancreatic head would appear to be as follows: --no frontal invasion of the pancreatic capsule; --no retropancreatic invasion or no evidence of invasion to the exposed cut surface even if the retroperitoneal tissues are invaded; --no lymph node metastasis or metastasis limited to the first lymph node group.
背景/目的：本研究针对过去13年中43例接受胰腺头部癌切除术的患者；8例存活3年或更长时间，并与17例在3年内死于癌症的患者在组织病理学扩散方面进行了比较。
对8例胰腺头部癌切除术后存活3年或更长时间的患者进行临床评估。将他们与17例在3年内死于癌症的患者进行组织学比较。
长期存活者有s0病变（胰腺包膜无正面侵犯）。无淋巴结转移，或如有转移，仅限于n1组。组织学检查显示，8例患者中有4例（50%）有rpe（阳性腹膜后侵犯）。所有患者均获得E-ew（-）（无暴露切面侵犯证据）。除1例IV期患者外，他们的分期（组织学癌症分期）为II期或III期。
根据我们对患者的评估结果，目前胰腺头部癌患者长期存活的前提条件似乎如下：——胰腺包膜无正面侵犯；——无胰后侵犯，或即使腹膜后组织受侵犯，也无暴露切面侵犯证据；——无淋巴结转移或转移仅限于第一组淋巴结。
