Palliative pancreatectomy with postoperative gemcitabine for patients with advanced pancreatic cancer
Palliative pancreatectomy with postoperative gemcitabine for patients with advanced pancreatic cancer
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DOI：
10.1007/s00535-007-2147-4
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发表时间：
2008-03-01
影响因子：
6.3
通讯作者：
Kuroda, Yoshikazu
中科院分区：
文献类型：
--
作者：
Fujino, Yasuhiro;Sakai, Tetsuya;Kuroda, Yoshikazu
背景。晚期胰腺癌患者的预后仍然很差。本研究旨在评估姑息性胰腺切除术后吉西他滨化疗。方法。共有 127 名患者在神户大学医院接受了姑息性胰腺切除术或姑息性不可切除吉西他滨治疗并进行了分析。结果。接受吉西他滨姑息性胰腺切除术的患者中位生存期为15个月，1年和3年生存率分别为60%和13%，而单独接受吉西他滨治疗的患者中位生存期仅为8个月，1年和3年生存率为26%和0%。多变量分析显示，吉西他滨是影响生存的最强因素，无远处转移和胰腺切除术也是显着因素。此外，接受吉西他滨镜下不完全切除的患者的中位生存期为22个月，1年和3年生存率分别为60%和40%。胰腺切除术使用吉西他滨改善了术后 3 个月的体能状态，与单独使用吉西他滨组相比，生存期更长。结论。显微镜下不完全胰腺切除术联合术后吉西他滨化疗在晚期胰腺癌中可能发挥作用。
Background. The prognosis of patients with advanced pancreatic cancer remains very poor. This study was designed to evaluate palliative pancreatic resection with postoperative gemcitabine chemotherapy. Methods. A total of 127 patients underwent palliative pancreatectomy or palliative nonresectable treatment with gemcitabine at Kobe University Hospital and were analyzed. Results. The median survival of patients receiving palliative pancreatectomy with gemcitabine was 15 months, and the 1- and 3-year survival rates were 60% and 13%, respectively, while that of patients receiving gemcitabine alone was only 8 months, and their 1- and 3-year survival rates were 26% and 0%. Multivariate analysis showed that gemcitabine was the strongest factor in survival, and no distant metastasis and pancreatectomy were also significant factors. In addition, the median survival of patients undergoing microscopically incomplete resection with gemcitabine was 22 months, and the 1- and 3-year survival rates were 60% and 40%. Pancreatectomy with gemcitabine improved the performance status 3 months after surgery, with longer survival compared with the gemcitabine alone group. Conclusions. Microscopically incomplete pancreatectomy with postoperative gemcitabine chemotherapy has a possible role in advanced pancreatic cancer.