LONG-TERM SURVIVAL AFTER RESECTION FOR DUCTAL ADENOCARCINOMA OF THE PANCREAS - IS IT REALLY IMPROVING
LONG-TERM SURVIVAL AFTER RESECTION FOR DUCTAL ADENOCARCINOMA OF THE PANCREAS - IS IT REALLY IMPROVING
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DOI：
10.1097/00000658-199501000-00007
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发表时间：
1995-01-01
影响因子：
9
通讯作者：
VANHEERDEN, JA
中科院分区：
文献类型：
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作者：
NITECKI, SS;SARR, MG;VANHEERDEN, JA
作者回顾了他们最近切除胰腺导管腺癌的经验。摘要背景资料胰腺导管腺癌传统上根治性切除后的5年生存率低于10%。最近，有几个组报道显着提高5年生存率（接近25%）的患者进行根治性切除术。MethodsInstitutional经验与186例连续（1981-1991年）的病理诊断导管腺癌进行胰腺切除术进行了审查。组织学标本的所有3年的幸存者（n = 31）进行了重新审查，由两名病理学家，一个内部和外部;非导管胰腺癌，然后被excluded.ResultsAfter组织学重新审查，12例患者没有导管腺癌，留下了174例患者进行分析（102名男性，72名女性，平均年龄63岁，范围34-82岁）。平均随访时间为22个月（范围4-109）。71%的患者行传统胰管切除术，9%行保留幽门切除术，20%行全胰切除术。住院死亡率为3%。28例患者（16%）有宏观不完全切除，98例（56%）有淋巴结转移的切除标本，21例（12%）有广泛的神经周围浸润。总体精算5年生存率为6.8%。淋巴结阴性患者的5年生存率高于淋巴结阳性患者（14%比1%，p < 0.001），而淋巴结阴性患者的5年生存率高于淋巴结阳性患者（
ObjectiveThe authors review their recent experience with resected pancreatic ductal adenocarcinoma.Summary Background DataDuctal adenocarcinoma of the pancreas has traditionally had a 5-year survival rate less than 10% after curative resection. Recently, several groups have reported markedly improved 5-year survival rates (approaching 25%) for patients undergoing curative resection.MethodsInstitutional experience with 186 consecutive patients (1981-1991) with pathologic diagnoses of ductal adenocarcinoma undergoing pancreatic resection was reviewed. Histologic specimens of all 3-year survivors (n = 31) were re-reviewed by two pathologists, one internal and one external; nonductal pancreatic cancers then were excluded.ResultsAfter histologic re-review, 12 patients did not have ductal adenocarcinoma, leaving a total of 174 patients for analysis (102 men, 72 women; mean age 63 years, range 34-82 years). Mean follow-up was 22 months (range 4-109). Classical pancreaticoduodenectomy was performed in 71%, pylorus-preserving resection in 9%, and total pancreatectomy in 20%. Hospital mortality was 3%. Twenty-eight patients (16%) had macroscopically incomplete resections; 98 (56%) had lymph node metastases within the resected specimens, and 21 patients (12%) had extensive perineural invasion. Overall actuarial 5-year survival was 6.8%. Five-year survival was greater for node-negative versus node-positive patients (14% vs. 1%, p < 0.001), and for smaller (