Invasive carcinoma derived from intraductal papillary mucinous carcinoma of the pancreas.
Invasive carcinoma derived from intraductal papillary mucinous carcinoma of the pancreas.
复制标题
源自胰腺导管内乳头状粘液癌的侵袭性癌。
作者：
T. Nakagohri;M. Konishi;Kazuto Inoue;Y. Tanizawa;T. Kinoshitá
背景/目标
大多数胰腺导管内乳头状黏液性肿瘤患者经手术治疗后预后良好。然而，由导管内乳头状黏液性癌衍生的浸润性癌患者常发生复发。本研究的目的是阐明导管内乳头状黏液癌起源的浸润性癌的临床病理特征。
方法论
我们对1995年6月至2001年12月在美国国家癌症中心东部医院接受胰腺切除术的29例导管内乳头状黏液性肿瘤患者进行了回顾性分析。
结果
10例导管内乳头状黏液癌浸润性癌中，7例有淋巴结转移，8例有腹膜后侵犯。导管内乳头状黏液癌浸润性癌的1、2、4年总的精算生存率分别为39%、26%、13%。术后复发：肝转移3例，癌性腹膜炎3例，局部复发3例，肺转移1例。腺瘤、非侵袭性癌、微侵袭性癌均存活，胰腺切除术后无复发。
结论
导管内乳头状黏液癌起源的浸润性癌预后较差。切缘阴性的胰腺切除是治疗本病的关键。
BACKGROUND/AIMS
Most patients with intraductal papillary mucinous tumors of the pancreas have a favorable prognosis after surgical treatment. However, recurrent disease frequently occurs in patients with invasive carcinoma derived from intraductal papillary mucinous carcinoma. The objective of this study was to clarify the clinicopathological features of invasive carcinoma derived from intraductal papillary mucinous carcinoma.
METHODOLOGY
We performed a retrospective review of the 29 patients with intraductal papillary mucinous tumor including 10 patients with invasive carcinoma who underwent pancreatic resection between June 1995 and December 2001 at the National Cancer Center Hospital East.
RESULTS
Of 10 patients with invasive carcinoma derived from intraductal papillary mucinous carcinoma, 7 patients had lymph node involvement and 8 patients had retroperitoneal invasion. The overall 1-, 2-, 4-year actuarial survival rate for invasive carcinoma derived from intraductal papillary mucinous carcinoma was 39%, 26%, 13%. Recurrence occurred as liver metastasis in 3 patients, carcinomatous peritonitis in 3, local recurrence in 3, and lung metastasis in 1. All patients with adenoma, non-invasive carcinoma, and minimally invasive carcinoma are alive without recurrent disease after pancreatic resection.
CONCLUSIONS
Patients with invasive carcinoma derived from intraductal papillary mucinous carcinoma had a worse prognosis. Margin-negative pancreatic resection is essential for treating this disease.