What prognostic factors are important in duodenal adenocarcinoma?
What prognostic factors are important in duodenal adenocarcinoma?
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DOI：
10.1001/archsurg.135.6.635
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发表时间：
2000-06-01
影响因子：
--
通讯作者：
Donohue, JH
中科院分区：
文献类型：
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作者：
Bakaeen, FG;Murr, MM;Donohue, JH
假设：十二指肠腺癌患者的生存取决于进行完全切除的能力和肿瘤分期。设计：回顾性病例系列。设置：三级护理转诊中心。患者：一组连续 101 名患者（平均年龄 62 岁），从 1976 年 1 月 1 日到 1996 年 12 月 31 日接受十二指肠腺癌手术。壶腹患者癌症被明确排除。平均随访时间为 4 年。 干预措施：手术对 68 名患者（67%）来说是治愈性的，对 33 名患者（33%）来说是姑息性的。治疗组中，50例（74%）患者接受了根治性手术，其中30例（60%）接受了胰十二指肠切除术； 15例（30%），保留幽门的胰十二指肠切除术； 5 例（10%），全胰腺切除术。 18 名患者 (26%) 使用了更有限的切除手术，其中 15 名患者 (83%) 进行了十二指肠节段切除术，3 名患者 (17%) 进行了经十二指肠切除术。主要结果 cmd 测量：肿瘤复发、患者生存率以及使用单变量和多变量分析与患者和肿瘤变量的相关性。结果：治疗组的精算 5 年生存率为 54%。未切除组中只有 1 名患者存活超过 3 年。淋巴结转移 (P = .002)，晚期肿瘤分期 (P
Hypothesis: Survival of patients with adenocarcinoma of the duodenum depends on the ability to perform a complete resection and the tumor stage.Design: Retrospective case series.Setting: Tertiary care referral center.Patients: A cohort of 101 consecutive patients (mean age, 62 years), undergoing surgery for duodenal adenocarcinoma from January 1, 1976, through December 31, 1996. Patients with ampullary carcinoma were specifically excluded. Mean duration of follow-up was 4 years.Interventions: Surgery was curative in 68 patients (67%) and palliative in 33 patients (33%). Of the curative group, 50 patients (74%) underwent radical surgery, ie, 30 (60%), pancreaticoduodenectomy; 15 (30%), pylorus-preserving pancreaticoduodenectomy; and 5 (10%), total pancreatectomy. A more limited resection procedure was used in 18 patients (26%) involving a segmental duodenal resection in 15 (83%) and a transduodenal excision in 3 (17%).Main Outcomes cmd Measures: Tumor recurrence, patient survival, and correlation with patient and tumor variables using univariate and multivariate analysis.Results: Actuarial 5-year survival for the curative group was 54%. Only 1 patient in the unresected group survived beyond 3 years. Nodal metastasis (P = .002), advanced tumor stage (P