Survival Analysis After Pancreatic Resection for Ampullary and Pancreatic Head Carcinoma: An Analysis of Clinicopathological Factors
Survival Analysis After Pancreatic Resection for Ampullary and Pancreatic Head Carcinoma: An Analysis of Clinicopathological Factors
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DOI：
10.1002/jso.21390
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发表时间：
2009-12-15
影响因子：
2.5
通讯作者：
Jiao, L. R.
中科院分区：
文献类型：
--
作者：
Sommerville, C. A. M.;Limongelli, P.;Jiao, L. R.
背景和目的：手术仍然是治疗胰腺和壶腹癌的唯一治疗选择。探讨胰十二指肠切除术后壶腹癌与胰头癌的生存差异。方法：回顾性分析2000年以前6年间接受根治性切除的壶腹或胰头腺癌患者。结果：共104例胰头癌和壶腹癌患者行胰十二指肠切除术（n = 65和n = 39）。组织学上，胰腺癌比壶腹癌更严重，有更多的淋巴结受累，更多的阳性切除边缘和血管和神经周围的侵犯。壶腹癌的中位无病生存率和总生存率明显优于胰腺癌（分别为17个月对9个月[P=0.001]和35个月对24个月[P=0.006]）。胰腺癌的精算5年无病生存率和总生存率分别为4.4%和10.5%，壶腹癌的精算5年无病生存率分别为27.9%和31.8%。多因素分析显示显微切除缘受累（P = 0.02）和三个以上淋巴结受累（P = 0.05）
Background and Objectives: Surgery remains the only curative option for the treatment of pancreatic and ampullary carcinomas. To examine the survival differences between ampullary and pancreatic head carcinomas after pancreaticoduodenectomy.Methods: A retrospective review of patients with ampullary or pancreatic head adenocarcinoma undergoing curative resection during a 6-year period prior to 2000.Results: A total of 104 patients underwent pancreaticoduodenectomy for pancreatic head and ampullary carcinomas (n = 65 and n = 39, respectively). Histologically, pancreatic cancer was worse, with more lymph node involvement and more positive resection margins and vascular and perineural invasions than found in ampullary carcinoma. The median disease-free and overall survival rates were significantly better for ampullary cancer when compared with pancreatic cancer (17 vs. 9 months [P=0.001] and 35 vs. 24 months [P=0.006], respectively). The actuarial 5-year disease-free and overall survival rates were 4.4% and 10.5%, respectively, for pancreatic carcinoma and 27.9% and 31.8%, respectively, for ampullary carcinoma. Multivariate analysis showed that microscopic resection margin involvement (P = 0.02) and involvement of over three nodes (P