Long-term survival in patients with locally advanced colon cancer after en bloc pancreaticoduodenectomy and colectomy
Long-term survival in patients with locally advanced colon cancer after en bloc pancreaticoduodenectomy and colectomy
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DOI：
10.1007/s10350-008-9318-0
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发表时间：
2008-10-01
影响因子：
3.9
通讯作者：
Kokudo, Norihiro
中科院分区：
文献类型：
--
作者：
Saiura, Akio;Yamamoto, Junji;Kokudo, Norihiro
目的：结肠癌直接侵犯胰头的手术指征存在争议。方法：1957年至2007年间，共有12例患者（8名男性）接受了胰十二指肠切除术联合右半结肠切除术治疗累及胰腺头的结肠癌。结果：平均年龄58岁（范围34 ~ 77岁）。术前有5例患者（41%）观察到瘘管形成。肿瘤累及仅十二指肠（n=4）、十二指肠/胰腺（n=3）、胃/胰腺（n=1）、十二指肠/胃（n=2）、十二指肠/肝脏（n=1）和胰腺（n=1）。仅发生一例术后死亡。组织学检查显示胰腺头部恶性侵犯9例（75%）。总的来说，手术后一年、三年和五年的生存率分别为75%、66%和55%。5名患者（41%）存活超过10年。结论：侵袭胰腺或十二指肠的晚期结肠癌行胰十二指肠切除术可提供良好的长期生存率。
PURPOSE: Surgical indications for colon cancer directly invading the pancreas head are controversial.METHODS: Between 1957 and 2007, a total of 12 patients (8 men) underwent pancreaticoduodenectomy combined with right hemicolectomy for colon cancer involving the pancreas head.RESULTS: Mean age was 58 (range, 34-77) years. Fistula formation was observed in five patients (41 percent) preoperatively. Tumor involvement was duodenum only (n=4), duodenum/pancreas (n=3), stomach/pancreas (n=1), duodenum/stomach (n=2), duodenum/liver (n=1), and pancreas only (n=1). Only one postoperative death was encountered. Histologic examination showed malignant invasion to the pancreas head in nine cases (75 percent). Overall one-year, three-year and, five-year survival rates after surgery were 75, 66, and 55 percent, respectively. Five patients (41 percent) survived for more than ten 10 years.CONCLUSIONS: Pancreaticoduodenectomy for advanced colon cancer invading the pancreas or duodenum provides favorable long-term survival.