Ozaki H, Hiraoka T, Mizumoto R, Matsuno S, Matsumoto Y, Nakayama T, Tsunoda T, Suzuki T, Monden M, Saitoh Y, Yamauchi H, Ogata Y
Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.
Surg Today. 1999;29(1):16-22. doi: 10.1007/BF02482964.
To investigate the prognostic factors of pancreatic cancer, a retrospective analysis of 193 patients who underwent curative resection was conducted. Of the 193 patients, 38 (20%) survived for more than 5 years, the 5-year survival rates for stages I, II, II, and IV disease being 41%, 17%, 11%, and 6%, respectively. According to a multivariate analysis, lymph node metastasis, intrapancreatic perineural invasion, and portal vein invasion were significant prognostic factors. Subsequently, a subgroup analysis concerning nodal metastasis and intrapancreatic perineural invasion was performed in 126 patients with records of these histological findings. In the group of patients without nodal metastasis, the 5-year survival rate for those without perineural invasion was 75%, whereas that for those with perineural invasion was 29%, the difference in survival of these subgroups being significant (P < 0.02). In the group of patients with nodal metastasis, the 5-year survival rate for those without perineural invasion was 17%, while that for those with perineural invasion was 10%. The most favorable 5-year survival of 89% was observed in the subgroup of patients with stage I disease without perineural invasion. Thus, pancreatic adenocarcinoma categorized by the combination of these independent types of biological behavior showed 5-year survival rates ranging from very high to low, indicating that these two factors play an important role in the prognosis of this disease.
为了研究胰腺癌的预后因素，对193例行根治性切除术的患者进行了回顾性分析。在这193例患者中，38例（20%）存活超过5年，I期、II期、III期和IV期疾病的5年生存率分别为41%、17%、11%和6%。根据多因素分析，淋巴结转移、胰腺内神经周围侵犯和门静脉侵犯是显著的预后因素。随后，对126例有这些组织学检查结果记录的患者进行了关于淋巴结转移和胰腺内神经周围侵犯的亚组分析。在无淋巴结转移的患者组中，无神经周围侵犯者的5年生存率为75%，而有神经周围侵犯者为29%，这些亚组的生存率差异有统计学意义（P<0.02）。在有淋巴结转移的患者组中，无神经周围侵犯者的5年生存率为17%，而有神经周围侵犯者为10%。在无神经周围侵犯的I期疾病患者亚组中观察到最有利的5年生存率为89%。因此，由这些独立类型的生物学行为组合分类的胰腺腺癌显示5年生存率从非常高到低不等，表明这两个因素在该疾病的预后中起重要作用。
