Analysis of Prognostic Factors in Metastatic Tumors of the Pancreas A Single-Center Experience and Review of the Literature
Analysis of Prognostic Factors in Metastatic Tumors of the Pancreas A Single-Center Experience and Review of the Literature
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DOI：
10.1097/mpa.0b013e3181bae9b3
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发表时间：
2010-03-01
期刊：
影响因子：
2.9
通讯作者：
Jovine, Elio
中科院分区：
文献类型：
--
作者：
Masetti, Michele;Zanini, Nicola;Jovine, Elio
目的：胰腺转移瘤很少见。手术的作用还不明确，长期生存的数据也很缺乏。方法：对2003-2008年间在我们科室观察到的胰腺转移瘤患者的数据进行回顾性分析。结果：共检索到234例胰腺继发性肿瘤患者的资料，其中包括9例连续观察到的患者。肾癌转移占全部病例的67.9%。通过多因素分析确定，预测预后较差的因素是确诊时的症状、同步肿瘤、未进行根治性手术以及原发肿瘤的病理诊断。与肾细胞癌的胰腺转移相比，黑色素瘤(P<；0.001)和肺癌(P=0.002)的转移与较差的存活率相关。肾细胞癌转移患者与乳腺癌、结直肠癌或肉瘤转移患者的存活率差异无统计学意义。结论：可能有一部分胰腺转移患者能够从手术中受益，从而提高长期存活率。诊断时的症状、原发肿瘤的表现、手术切除和病理诊断似乎是重要的预后因素。
Objectives: Pancreatic metastases are rare. The role of surgery is poorly defined, and data on long-term survival are lacking.Methods: Data from patients with pancreatic metastases observed in our division from 2003 to 2008 were retrospectively analyzed. In addition, the recent English medical literature was reviewed regarding series of patients with pancreatic secondary tumors.Results: Data from 234 patients including 9 consecutive patients observed in our division were retrieved. Metastasis from renal cell carcinoma accounted for 67.9% of all cases. Factors predictive of worse survival, as determined by multivariate analysis, were symptoms at diagnosis, synchronous tumors, radical-intent surgery not performed, and pathologic diagnosis of the primary tumor. Compared with pancreatic metastases from renal cell cancer, metastases from melanoma (P < 0.001) and lung cancer (P = 0.002) were associated with worse survival. The differences in survival of patients with renal cell cancer metastases and those with breast cancer, colorectal, or sarcoma metastases did not reach statistical significance.Conclusions: There may be a subset of patients with pancreatic metastases who are able to benefit from surgery with respect to improved long-term survival. Symptoms at diagnosis, presentation with primary tumor, surgical resection, and pathologic diagnosis seem to be important prognostic factors.