Vater壶腹癌局部切除术后长期存活相关因素的分析  

Determinants of long-term survival after local resection for ampulla of Vater carcinoma

作　　者：陈继业[1] 蔡守旺[1] 张文智[1] 黄晓强[1] 赵向前[1] 刘志伟[1] 冯玉泉[1] 董家鸿[1] 

机构地区：[1]中国人民解放军总医院肝胆外科,北京100853

出　　处：《中国现代普通外科进展》2009年第8期661-663,671,共4页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:探讨影响Vater壶腹癌行局部切除术后长期生存的相关因素,从而制订出更具针对性的治疗方案。方法:回顾性分析行局部切除术的21例Vater壶腹癌患者的临床资料,采用Kaplan-Meier法进行生存分析,独立样本t检验、Fisher精确检验。结果:全组无手术死亡,总的5年生存率为34.1%;15例患者术后出现明确的肿瘤复发和转移,其中10例患者(47.6%)出现局部复发,4例患者(19.0%)出现肝转移,1例患者(4.8%)出现腹壁转移;单因素分析表明,肿瘤直径、肿瘤分化程度是影响Vater壶腹癌患者术后生存时间的相关因素(P=0.014,0.015)。结论:Vater壶腹癌行局部切除术后预后良好,肿瘤直径和肿瘤分化程度是影响预后的相关因素,该术式适用于肿瘤直径<2cm、高分化、T1和T2期患者。Objective： To investigate determinants of long- term survival for ampulla of Vater carcinoma treated by local resection. Methods： Twenty-one patients with ampulla of Vater carcinoma who underwent local resection were reviewed. Kaplan-Meier method was used to analyze survival rate, independent t test and Fisher＇s exact test were used for statistical comparison. Results： No patient died of surgery. The overall 5-year survival was 34.1% . Disease recurred in 15 patients, including 10 locoregional recurrences,4 liver metastases, 1 peritoneal carcinomatose. Univariate analysis showed that tumour size （P=0.014）, the grade of cell differentiation （P=0.015）were significant prognostic factors of ampulla of Vater carcinoma. Conclusion：Local resection is associated with significant survival. Turnout size and the grade of cell differentiation are the most important factors influencing outcome after tocal resection. The procedure is indicated only in the patients with T1,T2 and well differentiated ampulla of Vater carcinoma which is smaller than 2cm in diameter.

关 键 词：VATER壶腹癌 局部切除术 Kaplan-Meier评估 预后 

分 类 号：R735.9[医药卫生—肿瘤]