Pancreatic Cancer With Paraaortic Lymph Node Metastasis A Contraindication for Radical Surgery?
Pancreatic Cancer With Paraaortic Lymph Node Metastasis A Contraindication for Radical Surgery?
复制标题
DOI：
10.1097/mpa.0b013e3181889e2d
复制
发表时间：
2009-01-01
期刊：
影响因子：
2.9
通讯作者：
Takeda, Shin
中科院分区：
文献类型：
--
作者：
Yamada, Suguru;Nakao, Akimasa;Takeda, Shin
目的：本研究的目的是确定胰腺癌伴主动脉旁淋巴结转移（No. 16[+]）的手术适应证。方法：1981年7月至2007年3月，335例胰腺癌患者在名古屋大学外科二科接受了扩展根治性手术，其中16号（+）患者45例。采用单因素和多因素分析对总生存率和临床病理参数进行分析。结果：虽然16（+）号患者与不能切除的患者生存率无显著差异，但16（+）号患者中仍有一些长期存活。16号（+）患者的多因素分析发现，年龄（59岁或以下）、肿瘤大小（bbb4cm）和病理证实的门静脉浸润（pPV[+]）是独立的预后因素。没有这些因素的16号（+）患者的生存率明显优于不能切除的患者。只有1个转移性主动脉旁淋巴结的患者的生存率也明显优于不能切除的患者，并倾向于优于2个以上转移性淋巴结的患者。结论：年龄≥60岁、肿瘤大小≤4cm、pPV（-）的No. 16（+）胰腺癌患者可从切除中获益。
Objectives: The purpose of this study was to determine the operative indications for pancreatic cancer with paraaortic lymph node metastases (No. 16 [+]).Methods: Between July 1981 and March 2007, 335 patients with pancreatic cancer including 45 No. 16 (+) patients underwent extended radical surgery at the Department of Surgery II, Nagoya University. The overall survival rates and clinicopathological parameters were analyzed using univariate and multivariate analyses.Results: Although there was no significant difference in survival between the No. 16 (+) patients and the unresectable cases, there were some long-term survivors among the No. 16 (+) patients. Multivariate analysis of the No. 16 (+) patients identified age (59 years or younger), tumor size (>4 cm), and pathologically confirmed portal invasion (pPV[+]) as independent prognostic factors. The survival of No. 16 (+) patients without these factors was significantly better than the unresectable cases. The survival of patients with only 1 metastatic paraaortic lymph node also was significantly better than the unresectable cases, and tended to be better than those with more than 2 metastatic nodes.Conclusions: No. 16 (+) pancreatic cancer patients with age 60 years or older, tumor size 4 cm or less, and pPV(-) may benefit from resection.