Management and prognosis of pancreatic cancer over a 30-year period.
Management and prognosis of pancreatic cancer over a 30-year period.
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DOI：
10.1038/sj.bjc.6605150
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发表时间：
2009-07-21
影响因子：
8.8
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中科院分区：
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背景：这项研究的目的是报告胰腺癌的诊断评估、护理模式和生存期随时间的变化。方法：研究对象为法国勃艮第消化系统癌症登记处的2986例胰腺癌患者，研究时间为30年(1976-2005)。采用非条件Logistic回归分析，找出与切除治愈和化疗有关的因素。进行多因素相对生存分析。结果：诊断程序发生了变化。超声和CT逐渐成为主要的诊断手段。阶段略有改善：1976年至1980年期间，第一至第二阶段的比例为2.8%，2001年至2005年期间为8.8%(P<；0.001)。切除治愈的病例比例也有类似的趋势，相应的百分比分别为4.5%和11.3%(P<；0.001)。5年相对生存率由2.0%提高到4.2%(P<；0.001)。在多变量相对生存分析中，病程仍然是一个重要的预后因素。分期、性别、年龄和组织学类型是影响预后的独立因素。结论：在30年期间，胰腺癌的诊断、切除、治愈和预后的阶段有很小的变化，尽管诊断方法有所改进。胰腺癌仍然是肿瘤学的一大挑战。
BACKGROUND: The aim of this study was to report on changes in the diagnostic assessment, patterns of care and survival over time for pancreatic cancers. METHODS: A total of 2986 cases of pancreatic cancer from the Digestive Cancer Registry of Burgundy (France) over a 30-year period (1976–2005) were considered. Non-conditional logistic regressions were carried out to identify the factors associated with resection for cure and with the use of chemotherapy. A multivariate relative survival analysis was carried out. RESULTS: Diagnostic procedures have changed. Ultrasonography and computed tomography progressively have become the major diagnostic procedures. There was a slight improvement in stage: the proportion of stage I–II was 2.8% in the 1976–1980 period and 8.8% in the 2001–2005 period (P<0.001). There was a similar trend in the proportion of cases resected for cure, the corresponding percentages being 4.5 and 11.3%, respectively (P<0.001). The 5-year relative survival increased from 2.0 to 4.2% (P<0.001). In the multivariate relative survival analysis, the period remained a significant prognostic factor. Stage, sex, age and histology were independent prognostic factors. CONCLUSION: Over a 30-year period, there were minor changes in the stage at diagnosis, resection for cure and prognosis of pancreatic cancers, although there were improvements in the diagnostic modalities. Pancreatic cancer still represents a major challenge in oncology.