Analysis of long-term survivors after surgical resection for pancreatic cancer
Analysis of long-term survivors after surgical resection for pancreatic cancer
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DOI：
10.1097/01.mpa.0000202953.87740.93
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发表时间：
2006-04-01
期刊：
影响因子：
2.9
通讯作者：
Park, Yong-Hyun
中科院分区：
文献类型：
--
作者：
Han, Sung-Sik;Jang, Jin-Young;Park, Yong-Hyun
目的：本研究的目的是确定胰腺癌手术切除的结果，并描述实际长期幸存者的临床病理特征。方法：在 789 例胰腺癌患者中，我们回顾性分析了 1985 年至 1999 年间接受手术的 242 例患者。其中 123 例患者进行了根治性总结切除术。我们分析了手术治疗的总体结果，比较了长期幸存者和短期幸存者的临床病理特征，并重新评估了长期幸存者的组织学切片。结果：手术切除后中位生存期和累积5年生存率分别为14.8个月和12.1%。肿瘤大小、美国癌症联合委员会分期、切缘受累和淋巴结转移是重要的预后因素。 11名患者存活超过5年。一些具有淋巴结转移、肿瘤体积大等预后不良因素的患者存活了5年以上。长期幸存者的组织学重新评估发现 4 例变异腺癌（间变性癌、粘液性非囊性腺癌 [n = 2] 和未分化癌）。结论：即使对于预后不良的患者，也应尝试积极手术切除。由于长期存活者的病理类型多种多样，典型的胰腺导管腺癌的存活率可能较差。
Objectives: The purpose of this study was to determine the outcome of surgical resection for pancreatic cancer and to characterize the clinicopathologic features of actual long-term survivors.Methods: Of the 789 pancreatic cancer patients, we retrospectively analyzed 242 patients who underwent an operation between 1985 and 1999. Sumical resection with curative intent was performed in 123 patients. We analyzed the overall results of surgical treatment, compared the clinicopathologic features between long-term and short-term survivors, and reevaluated the histological slides of the long-term survivors.Results: Median survival and cumulative 5-year survival rate after surgical resection were 14.8 months and 12.1%. Tumor size, American Joint Committee on Cancer stage, resection margin involvement, and lymph node metastases were the significant prognostic factors. Eleven patients survived for more than 5 years. Some patients with poor prognostic factors such as lymph node metastasis and big tumor size survived for more than 5 years. Histological reevaluation in the long-term survivors revealed 4 cases of variant adenocarcinoma (anaplastic carcinoma, mucinous noncystic adenocarcinoma [n = 2], and undifferentiated carcinoma).Conclusions: Active surgical resection should be attempted even in patients with poor prognostic factors. As there were various types of pathology among the long-term survivors, typical ductal adenocarcinoma of the pancreas might have a poorer survival rate.