Pancreatoduodenectomy for distal cholangiocarcinoma: Prognostic impact of lymph node metastasis
Pancreatoduodenectomy for distal cholangiocarcinoma: Prognostic impact of lymph node metastasis
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DOI：
10.1007/s00268-006-0224-0
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发表时间：
2007-02-01
影响因子：
2.6
通讯作者：
Sueda, Taijiro
中科院分区：
文献类型：
--
作者：
Murakami, Yoshiaki;Uemura, Kenichiro;Sueda, Taijiro
背景：本研究的目的是确定对远端胆管癌接受胰十二指肠切除术的患者有用的预后因素。方法：对 36 例接受胰十二指肠切除术的远端胆管癌患者的记录进行回顾性分析。通过单变量和多变量分析检查可能影响生存的潜在临床病理预后因素。结果：没有死亡。 1 年、3 年和 5 年的总生存率分别为 75%、54% 和 50%（中位生存时间为 26 个月）。单变量分析发现，年龄（≥65岁）、胰腺侵犯、十二指肠侵犯、淋巴结转移、神经周围侵犯和手术切缘阳性是预后不良的显着预测因素（P < 0.05）。此外，通过多变量分析发现淋巴结转移是不良预后的重要独立预测因子（P = 0.043）。此外，受累淋巴结数量为2个或更少的患者与阳性淋巴结数量为3个或更多的患者之间的5年生存率存在显着差异（P < 0.001）。具有 3 个或更多阳性淋巴结的患者组中没有 2 年幸存者。结论：这些结果表明，表现出转移性疾病的淋巴结的存在和数量可能有助于预测因远端胆管癌接受胰十二指肠切除术的患者的术后结果。
Background: The aim of this study was to identify useful prognostic factors in patients undergoing pancreatoduodenectomy for distal cholangiocarcinoma.Methods: The records of 36 patients with distal cholangiocarcinoma undergoing pancreatoduodenectomy were retrospectively reviewed. Potential clinicopathological prognostic factors that may affect survival were examined by univariate and multivariate analysis.Results: There was no mortality. Overall survival rates were 75%, 54%, and 50% for 1, 3 and 5 years, respectively (median survival time, 26 months). Univariate analysis found that age (>= 65 years), pancreatic invasion, duodenal invasion, lymph node metastasis, perineural invasion and a positive surgical margin were significant predictors of poor prognosis (P < 0.05). Furthermore, lymph node metastasis was found to be a significant independent predictor of poor prognosis by multivariate analysis (P = 0.043). Moreover, there were significant differences in the 5-year survival between patients with 2 or less involved lymph nodes and those with 3 or more positive nodes (P < 0.001). There were no 2-year survivors of the group of patients with 3 or more positive nodes.Conclusions: These results suggest that the presence and number of lymph nodes exhibiting metastatic disease might be useful in predicting the postsurgical outcome in patients undergoing pancreatoduodenectomy for distal cholangiocarcinoma.