Analysis of 5-Year Survivors After a Macroscopic Curative Pancreatectomy for Invasive Ductal Adenocarcinoma
Analysis of 5-Year Survivors After a Macroscopic Curative Pancreatectomy for Invasive Ductal Adenocarcinoma
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DOI：
10.1007/s00268-010-0570-9
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发表时间：
2010-08-01
影响因子：
2.6
通讯作者：
Hiraoka, Nobuyoshi
中科院分区：
文献类型：
--
作者：
Shimada, Kazuaki;Sakamoto, Yoshihiro;Hiraoka, Nobuyoshi
对1990年至2003年期间因浸润性导管腺癌行大体根治性胰腺切除术且术后观察时间超过5年的229例患者进行回顾性分析。对生存5年以上的患者与5年内死亡的患者进行比较。对5年生存者的复发模式和影响5年生存率的因素进行了调查，40例（17%）患者生存超过5年，生存5年后再生存5年的比例为72%。多因素考克斯风险分析显示，手术切缘阴性、淋巴管浸润频率低、IIB期a/1000、淋巴结转移阴性是与长期生存相关的独立因素。30例患者（75%）存活，无复发，8例（20%）在7.3年内死于疾病。胰腺内神经侵犯是预测40例5年生存者长期生存的重要因素，有限的肿瘤扩散伴淋巴结转移阴性是生存5年以上的重要因素。存活5年者胰内神经侵犯的发生率低，影响了随后的良好生存。
Surgical resections for invasive ductal adenocarcinoma of the pancreas can provide the only chance of cure, although the 5-year survivors are not always equated with cure.A total of 229 who underwent a macroscopic curative pancreatectomy for invasive ductal adenocarcinoma between 1990 and 2003 and have been observed for more than 5 years from the time of resection were retrospectively analyzed. The data of patients who survived more than 5 years were compared with those died within 5 years. The recurrence pattern and factors that influenced an additional 5-year survival in the 5-year survivors were investigated.Forty patients (17%) survived more than 5 years, and the survival rate for an additional 5 years after surviving 5 years was 72%. A multivariate Cox hazards analysis showed that negative surgical margins status, less frequency of lymphatic invasion, stage a parts per thousand currency sign IIB, and negative lymph node involvement were independent factors associated with long-term survival. Thirty patients (75%) were alive without recurrence, and eight (20%) died of disease within 7.3 years. Intrapancreatic nerve invasion was a significant factor predicting additional long-term survival in the 40 5-year survivors.Limited cancer extension with negative lymph node metastases significantly contributes to the chance of surviving more than 5 years. A low incidence of intrapancreatic nerve invasion in the 5-year survivors affects the subsequent favorable survival.