Analysis of 300 consecutive cases of pancreatic adenocarcinoma in a single-center in China
Analysis of 300 consecutive cases of pancreatic adenocarcinoma in a single-center in China
复制标题
中国单中心连续300例胰腺腺癌分析
DOI：
10.1016/s1499-3872(16)60066-8
复制
发表时间：
2016-04-01
影响因子：
3.3
通讯作者：
Jiang, Hong-Chi
中科院分区：
文献类型：
--
作者：
Lin, Han;Ma, Yong;Jiang, Hong-Chi
背景：有关胰腺癌患者预后指标的报道大多来自发达国家。本研究旨在探讨中国人胰腺癌患者的预后指标。方法：共纳入300例胰腺癌根治性切除患者。结果：3427例确诊为胰腺癌的患者中，仅300例(8.8%)符合根治性切除条件。中位生存期19个月，1、3、5年生存率分别为72.5%、28.0%、23.4%。影响预后的因素包括社会经济状况、吸烟史、症状、高血糖和各种肿瘤特征，包括手术前后神经和血管侵犯、淋巴结转移和CA19-9水平。与手术相关的预后指标包括手术时间、出血和输血、胰瘘和并发症。死亡的独立预测因素包括社会经济状况差、吸烟史、症状、CA19-9、神经周围侵犯和淋巴结转移、瘘管分级和并发症。多因素分析显示，胰腺癌根治性切除患者的生存率与手术切缘、辅助化疗无关。结论：中国地区胰腺癌根治性切除患者的生存率接近发达国家，但根治性切除率远低于发达国家。社会经济状况、症状和CA19-9是三个最显著的预后因素，有助于患者的选择和围手术期的护理。
BACKGROUND: Most of the reports on the prognostic indicators of patients with pancreatic adenocarcinoma are from developed countries. The present study focused on the prognostic indicators of Chinese patients with pancreatic adenocarcinoma.METHODS: A total of 300 patients with pancreatic adenocarcinoma who had undergone curative resection were included. The resection and R0/R1 resection rates for adenocarcinomas from different parts of the pancreas were calculated and clinical characteristics were analyzed.RESULTS: In 3427 patients diagnosed with pancreatic adenocarcinomas, only 300 (8.8%) were eligible for radical resection. The total median survival of these patients was 19 months, and their 1-, 3-, and 5-year survival rates were 72.5%, 28.0% and 23.4%, respectively. The prognostic factors included socioeconomic status, smoking history, symptoms, high blood glucose, and various tumor characteristics, including perineural and vascular invasion, lymph node metastases, and CA19-9 levels before and after operation. Operation-associated prognostic indicators included operation time, blood loss and transfusions, pancreatic fistula, and complications. Independent predictors of mortality included poor socioeconomic status, smoking history, symptoms, CA19-9, perineural invasion and lymph node metastasis, grade of fistula and complications. Patient survival was not correlated with either resection margin or adjuvant chemotherapy in multivariate analysis.CONCLUSIONS: The survival rates of patients with curative resection for pancreatic adenocarcinoma in China are close to those in developed countries, but curative resection rate is far below. Socioeconomic status, symptoms, and CA19-9 are the three most prominent prognostic factors, which are helpful in patient selection and perioperative care.