Results of 1001 pancreatic resections for invasive ductal adenocarcinoma of the pancreas.

Results of 1001 pancreatic resections for invasive ductal adenocarcinoma of the pancreas.
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1001 例胰腺浸润性导管腺癌胰腺切除术的结果。

DOI：
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发表时间：
1997
期刊：
Archives of Surgery
影响因子：
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通讯作者：
R. Denno
R. Denno
中科院分区：
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文献类型：
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作者：
K. Hirata;Takashi Sato;M. Mukaiya;K. Yamashiro;M. Kimura;K. Sasaki;R. Denno

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客观的 评估胰腺浸润性导管腺癌患者胰腺切除的近期结果。 设计 回顾性研究。 环境 日本胰脏外科学会所属的77家医疗机构。 患者 1991年1月1日至1994年12月31日期间，有101名患者接受了胰腺切除术。 主要成果指标 根据国际抗癌联盟修改后的 TNM 分类，胰腺癌手术后的发病率和生存率。 结果 胰腺切除术后，术后1年和3年的累积生存率分别为44.5%和10.3%。早期癌症患者的生存时间更长，I期和II期癌症患者的累计3年生存率分别为50.4%和45.5%； III期、IVa期和IVb期癌症患者的生存率分别为17.6%、5.7%和0%。 N1 或 N2 转移患者的生存率没有明显差异，两组的生存率均明显优于 N3 转移患者 (P < .001)。未进行淋巴结清扫的患者（平均生存期，326.4 天）和接受淋巴结清扫术 (D1) 的患者（平均生存期，478.2 天）之间观察到 N1 转移的术后生存时间存在显着差异（P < 或 = 0.01）。 结论 近期胰腺癌切除治疗的效果普遍不理想。尽管N1转移患者接受N1淋巴结清扫术（D1）可以改善预后，但晚期癌症的广泛淋巴结清扫术并不一定能产生良好的预后。
OBJECTIVE To evaluate the recent results of pancreatic resection in patients with invasive ductal adenocarcinoma of the pancreas. DESIGN Retrospective study. SETTING Seventy-seven medical facilities belonging to the Japan Society of Pancreatic Surgery. PATIENTS One thousand one patients who underwent a resection of the pancreas between January, 1, 1991, and December 31, 1994. MAIN OUTCOME MEASURES Morbidity and survival after surgery for pancreatic cancer according to the modified TNM classification of the International Union Against Cancer. RESULTS After pancreatic resection, the cumulative postoperative survival rates at 1 and 3 years were 44.5% and 10.3%, respectively. Patients with early-stage cancers had a more prolonged survival time, ie, the cumulative 3-year survival rates for patients with stage I or stage II cancers were 50.4% and 45.5%, respectively; the survival rates for patients with stage III and stage IVa and IVb cancers were 17.6%, 5.7%, and 0%, respectively. The survival rate for patients with N1 or N2 metastasis did not differ appreciably, and both groups had significantly better survival rates than patients with N3 metastasis (P < .001). A significant difference in the postoperative survival time of N1 metastasis was observed between patients with no lymph node dissection (mean survival, 326.4 days) and patients who received a lymph node dissection (D1) (mean survival, 478.2 days) (P < or = .01). CONCLUSIONS The recent results of pancreatic resection for invasive ductal adenocarcinoma of the pancreas are generally unsatisfactory. Although the outcome of the patients with an N1 metastasis can be improved if they receive N1 lymph node dissection (D1), an extensive lymph node dissection in advanced cancers does not necessarily produce a favorable prognosis.