Patients with hepatic oligometastatic pancreatic body/tail ductal adenocarcinoma may benefit from synchronous resection
Patients with hepatic oligometastatic pancreatic body/tail ductal adenocarcinoma may benefit from synchronous resection
复制标题
肝寡转移性胰腺体/尾部导管腺癌患者可能受益于同步切除
DOI：
10.1016/j.hpb.2019.05.015
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发表时间：
2020-01-01
期刊：
影响因子：
2.9
通讯作者：
Sun, Yongwei
中科院分区：
文献类型：
--
作者：
Yang, Jianyu;Zhang, Junfeng;Sun, Yongwei
背景：基于肿瘤学研究进展，原发性胰腺导管腺癌（PDAC）和肝转移的高选择性患者的同步切除术显示出安全的手术结果，低发病率和死亡率，正在被接受。我们还试图确定哪些病人会从手术中受益。方法：回顾性分析2012年1月至2017年10月48例原发性PDAC和肝转移同步切除的患者。其中23例行少转移性同步切除。结果：多数同步切除的PDAC患者行肝楔切除术，无少转移患者行半肝切除术。同步切除患者的中位总生存期（OS）为7.8个月。肝少转移性PDAC患者的生存期比非少转移性同步切除患者、全身化疗患者和缓和治疗患者更长（16.1 vs 6.4个月，P = 0.02; 16.1 vs 7.6个月，P = 0.02; 16.1 vs 4.3个月，P < 0.0001）。进一步分析显示，少转移患者的局部胰体/尾PDAC的OS优于非少转移同步切除患者（16.8个月vs 7.05个月，P = 0.0004）和全身化疗患者（16.8个月vs 8个月，P = 0.003）。结论：胰体/胰尾PDAC合并肝少转移患者可行同步切除。
Background: Synchronous resection of primary pancreatic ductal adenocarcinoma (PDAC) and liver metastases in highly selective patients is being accepted based on oncology research progress showing safe surgical outcomes with low morbidity and mortality. We also tried to determine patients who would benefit from the operation.Methods: From January 2012 to October 2017, 48 patients who underwent synchronous resection of primary PDAC and liver metastases were retrospectively evaluated. Twenty-three of them underwent oligometastatic synchronous resection.Results: The majority of synchronous resection PDAC patients underwent hepatic wedge resection, and no oligometastatic patient was treated with hemihepatectomy. The median overall survival (OS) of the synchronous resection patients was 7.8 months. Hepatic oligometastatic PDAC patients had a longer OS than that of non-oligometastatic synchronous resection patients, systemic chemotherapy patients and palliative patients (16.1 vs 6.4 months, P = 0.02; 16.1 vs 7.6 months, P = 0.02; 16.1 vs 4.3 months, P < 0.0001; respectively). Further analysis showed that localized pancreatic body/tail PDAC had a better OS in oligometastatic patients than in non-oligometastatic synchronous resection patients (16.8 months vs 7.05 months, P = 0.0004) and systemic chemotherapy patients (16.8 months vs 8 months, P = 0.003).Conclusion: Patients with pancreatic body/tail PDAC with liver oligometastases can benefit from synchronous resection.