Surgery for isolated liver metastases from pancreatic cancer
Surgery for isolated liver metastases from pancreatic cancer
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DOI：
10.1007/s13304-015-0283-6
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发表时间：
2015-03-01
期刊：
影响因子：
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通讯作者：
Jovine，Elio
中科院分区：
文献类型：
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作者：
Zanini，Nicola;Lombardi，Raffaele;Jovine，Elio
胰腺导管腺癌肝转移的切除术一直不被鼓励，因为它通常被认为不会提高生存率。然而，潜在的预后因素的作用尚不清楚，普遍接受的策略还没有提出。2003年至2014年期间，15例胰腺癌孤立性同步或异时转移患者在我科接受了肝切除术。分析潜在预后因素的作用以预测生存。行右半肝切除1例，双肝段切除1例，楔形切除13例。11例患者同时接受胰腺和肝脏切除术治疗同步疾病。中位总生存期（OS）为9.1个月（95%CI 8.6-9.7）。唯一显著影响生存率的潜在预后因素是转移的时间（异时性与同步性）。异时性疾病患者的中位OS为11.4个月（95% CI 0-25.1）vs. 8.3个月（95% CI 6.9-9.7），p= 0.038。对于大多数患者，不建议手术治疗胰腺癌肝转移。如果考虑切除，转移性疾病的时间可能是手术后生存的预后因素。
The resection of liver metastases from pancreatic ductal adenocarcinoma has been discouraged because it is commonly thought that it does not improve survival. However, the role of potential prognostic factors is unclear, and universally accepted strategies have not been proposed. Between 2003 and 2014, 15 patients with isolated synchronous or metachronous metastases from pancreatic cancer underwent liver resection in our department. The role of potential prognostic factors was analyzed to predict survival. One right hepatectomy, 1 bisegmentectomy and 13 wedge resections were performed. Eleven patients underwent simultaneous pancreatic and liver resection for synchronous disease. The median overall survival (OS) was 9.1 months (95 % CI 8.6–9.7). The only potential prognostic factor that significatively affected survival was the timing of metastases (metachronous vs. synchronous). Median OS in patients with metachronous disease was 11.4 months (95 % CI 0–25.1) vs. 8.3 months (95 % CI 6.9–9.7),p= 0.038. Surgery for liver metastases from pancreatic cancer is not suggested for most patients. If resection is considered, timing of metastatic disease could be a prognostic factor for survival after surgery.