Adenosquamous carcinoma of the pancreas: A single-institution experience comparing resection and palliative care
Adenosquamous carcinoma of the pancreas: A single-institution experience comparing resection and palliative care
复制标题
DOI：
10.1016/j.jamcollsurg.2008.03.027
复制
发表时间：
2008-09-01
影响因子：
5.2
通讯作者：
Que, Florencia G.
中科院分区：
文献类型：
--
作者：
Smoot, Rory L.;Zhang, Lizhi;Que, Florencia G.
背景：腺鳞癌是一种罕见的胰腺外分泌恶性肿瘤。以前的文献报道这些患者的生存率很低。我们研究了我们的单机构的经验，这种肿瘤比较生存的外科切除术和姑息性therapy.Study设计：，记录进行了审查，在1985年至2003年期间评估的胰腺腺鳞癌患者。对病理学标本进行了审查。生存率采用Kaplan-Meier法计算，分类变量比较采用卡方分析。结果：23例患者被确定为胰腺腺鳞癌。12例患者进行了根治性切除和I I患者没有手术或姑息性旁路手术。切除组的平均年龄为69岁（7名男性）。在非手术组中，平均年龄为65岁（6名男性）。手术方式包括标准胰腺切除术（PD）4例，保留幽门PD 3例，胰尾切除术5例。中位住院时间为13.5天（7-30天）。死亡包括胃排空延迟（4例患者）、渗漏（2例患者）、浅表皮肤感染、脓肿和GI出血（各1例患者）。切除组无手术或住院死亡。RO切除术的中位生存期为14.4个月相比，8个月的R1和4.8个月的姑息治疗patients undergoing palliative therapies.CONCLUSIONS：我们的单机构的经验与胰腺腺鳞癌切除术和姑息治疗的回顾性分析表明，可以接受RO切除术的患者生存期较长。虽然这是一个小系列，我们仍然建议这些患者切除。
BACKGROUND: Adencsquamous carcinoma is a rare malignancy of the exocrine pancreas. Previous literature has reported dismal survival for these patients. We examined our single-institution experience with this tumor to compare survival for sugical resection and palliative therapy.STUDY DESIGN:, Records were reviewed for patients with adenosquamous pancreatic cancer evaluated during the years 1985 to 2003. Pathology specimens were reviewed. Survival was calculated by Kaplan-Meier method and categorical variables were compared with Chi-square analysis. A p value < 0.05 was considered significant.RESULTS: Twenty-three patients were identified with adenosquamous carcinoma of the pancreas. Twelve patients underwent curative resection and I I patients had either no surgery or a palliative bypass procedure. For-the resection group the mean age was 69 years (7 men). In the nonoperative group the mean age was 65 years (6 men). Operative procedures included standard pancreaticoduodenectomy (PD), 4 patients; pyloruspreserving PD, 3 patients; and distal pancreatectomy, 5 patients. Median length of stay was 13.5 days (7-30 d). Morbidity included delayed gastric emptying (4 patients), leak (2 patients), superficial skin infection, abscess, and GI bleed (I patient each). There was no operative or inhospital mortality in the resection group. For RO resection median survival was 14.4 months compared to 8 months for R1 and 4.8 months for patients undergoing palliative therapies.CONCLUSIONS: The retrospective review of our single-institution experience with resection and palliative care for adenosquamous cancer of the pancreas has demonstrated a longer survival for patients that can undergo an RO resection. Although this is a small series we continue to recommend resection for these patients.