Pancreatic ductal adenocarcinoma: long-term survival does not equal cure.
Pancreatic ductal adenocarcinoma: long-term survival does not equal cure.
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DOI：
10.1016/j.surg.2012.05.020
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发表时间：
2012-09
期刊：
影响因子：
3.8
通讯作者：
Warshaw, Andrew L.
中科院分区：
文献类型：
--
作者：
Ferrone, Cristina R.;Pieretti-Vanmarcke, Rafael;Bloom, Jordan P.;Zheng, Hui;Szymonifka, Jackye;Wargo, Jennifer A.;Thayer, Sarah P.;Lauwers, Gregory Y.;Deshpande, Vikram;Mino-Kenudson, Mari;Fernandez-del Castillo, Carlos;Lillemoe, Keith D.;Warshaw, Andrew L.
胰腺导管腺癌占胰腺癌的90%，是美国癌症死亡的重要原因。手术切除仍然是延长生存期的唯一治疗方法，但即使在根治性切除后，5年生存率也很低。我们的目的是确定胰腺导管腺癌切除术后长期生存的预后因素，这些因素与患者、治疗和肿瘤生物学有关。回顾性分析确定了1985年2月至2010年12月期间接受胰腺癌切除术的959例患者，其中499例在2006年11月之前切除，代表了我们在本研究中描述的队列。评估患者、肿瘤和治疗相关变量与5年和10年总生存率的相关性。在499名患者中，49%为女性，中位年龄为65岁。大多数患者患有IIb期疾病（60%）。胰腺癌切除术后实际5年生存率为19%（95/499），实际10年生存率为10%（33/329）。预测5年和10年生存率的重要临床病理因素是阴性切缘和阴性淋巴结状态。有趣的是，41%（39/95）的长期存活者有阳性淋巴结，24%（23/95）有阳性切缘。胰腺导管腺癌表现出非常异质性的生物学，但切缘阴性和淋巴结阴性的患者更有可能在切除后存活5年。然而，我们的系列研究表明，癌症的生物学而不是简单的病理因素决定了患者的预后。
Pancreatic ductal adenocarcinoma represents 90% of pancreatic cancers and is an important cause of cancer death in the United States. Operative resection remains as the only treatment providing prolonged survival, but even after a curative resection, 5-year survival rates are low. Our aim was to identify the prognostic factors for long-term survival after resection of pancreatic ductal adenocarcinoma related to patients, treatments, and tumor biology. Retrospective review identified 959 patients who underwent resection of their pancreatic adenocarcinoma between February 1985 and December 2010, of whom 499 were resected before November 2006 and represent the cohort we describe in this study. Patient, tumor, and treatment-related variables were assessed for their associations with 5- and 10-year overall survival. Of the 499 patients, 49% were female and median age was 65 years. The majority of patients had stage IIb disease (60%). Actual 5-year survival after resection of pancreatic adenocarcinoma was 19% (95/499), and actual 10-year survival was 10% (33/329). Significant clinicopathologic factors predicting 5- and 10-year survival were negative margins and negative nodal status. Interestingly, 41% (39/95) of long-term survivors had positive nodes and 24% (23/95) had positive margins. Pancreatic ductal adenocarcinoma demonstrates a very heterogeneous biology, but patients with negative resection margins and node negative cancers are more likely to survive 5 years after resection. However, our series demonstrates that the biology of the cancer rather than simple pathologic factors determine a patient’s prognosis.
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影响因子：
3.2
作者：
Sohn, TA;Yeo, CJ;Lillemoe, KD
通讯作者：
Lillemoe, KD
DOI：
10.1016/j.jamcollsurg.2004.01.008
发表时间：
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影响因子：
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作者：
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影响因子：
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作者：
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通讯作者：
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