Survival after pancreaticoduodenectomy for periampullary adenocarcinoma: an update
Survival after pancreaticoduodenectomy for periampullary adenocarcinoma: an update
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DOI：
10.1053/ejso.2001.1162
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发表时间：
2001-09-01
期刊：
影响因子：
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通讯作者：
Gouma, DJ
中科院分区：
文献类型：
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作者：
van Geenen, RCI;van Gulik, TM;Gouma, DJ
目的：壶腹周围肿瘤行胰十二指肠切除术后生存率有限。在过去的十年中，围手术期管理得到了改善，发病率和死亡率下降。这项研究的目的是分析最近的生存数据后，pancreaticostomy，以确定影响survival.Methods：从1992年10月至1998年9月，204例导管腺癌的胰头（108），远端胆管（32），壶腹（64）谁进行了标准pancreaticostomy切除术，进行了分析，组织学和肿瘤状态。采用Kaplan-Meier法计算生存期。结果：胰头癌、远端胆管癌和壶腹癌切除后的中位生存期分别为16*、25和24* 个月（*P=0.008）。在单变量分析中，静脉切除术、输血超过4个浓缩红细胞、肿瘤切缘阳性、淋巴结转移和肿瘤分化差显著降低生存率。在多变量分析中，阳性切除边缘，淋巴结转移，肿瘤分化差独立影响survival.Conclusions：切除边缘，淋巴结状态和肿瘤分化是独立的预后因素。标准胰十二指肠切除术后壶腹周围肿瘤的生存率没有提高。(C)2001年哈考特出版社有限公司
Aim: Survival after pancreaticoduodenectomy for periampullary tumours is limited. Over the last decade perioperative management has improved and morbidity and mortality decreased. The aim of the study was to analyse recent survival data after pancreaticoduodenectomy and to determine factors that influence survival.Methods: From October 1992 to September 1998, 204 patients with a ductal adenocarcinoma in the pancreatic head (108), distal bile duct (32), and ampulla (64) who underwent standard pancreaticoduodenectomy, were analysed with regard to histology and tumour status. Survival was calculated by using the Kaplan-Meier method. Risk factors were identified in a univariate and multivariate analysis.Results: Median survival after resection for carcinoma of the pancreatic head, distal bile duct, and ampulla were 16*, 25 and 24* months, respectively (*P=0.008). In the univariate analysis vein resection, blood transfusion of more than four packed red cells, the presence of tumour positive resection margins, lymph-node metastases and poor tumour differentiation significantly decreased survival. In the multivariate analysis positive resection margins, lymph-node metastases, and poor tumour differentiation independently influenced survival.Conclusions: Resection margins, lymph-node status and tumour differentiation are independent prognostic factors. Survival after standard pancreaticoduodenectomy for periampullary tumours has not improved. (C) 2001 Harcourt Publishers Ltd.