胰腺癌2061例外科手术的疗效与预后分析  

Efficacy and prognosis analysis of 2061 cases of pancreatic cancer resection

作　　者：金钢[1] 邵卓[1] 胡先贵[1] 张怡杰[1] 刘瑞[1] 周颖奇[1] 邵成浩[1] 何天霖[1] 李刚[1] 经纬[1] 宋彬[1] 

机构地区：[1]第二军医大学长海医院胰腺外科,上海200433

出　　处：《中华胰腺病杂志》2013年第1期1-4,共4页Chinese Journal of Pancreatology

基　　金：国家自然科学基金（30772139）

摘　　要：目的 单中心研究胰腺癌的手术治疗效果及相关因素分析。方法回顾性分析长海医院胰腺外科2000年1月至2011年12月诊治的2061例胰腺癌患者的诊治情况和临床数据，并对患者进行随访，随访截止至2012年9月30日。结果所有收治的胰腺癌患者中，根治性手术治疗1657例（80．4％），姑息性手术治疗271例（13．1％），剖腹探查活检133例。根治性切除组1、3、5年牛存率分别为60．3％、21．1％、10．9％，术后中位生存时间为19．6个月，其中180例患者术后存活超过5年；姑息性手术组术后中位生存时间为7．2个月。胰腺癌患者手术切除率和术后3年生存期分别由2000年至2003年的75．3％和12．4％提高到2008年至2009年的82．5％和22．1％。通过Cox回归模型发现，大血管侵犯、淋巴结转移、神经浸润以及肿瘤分化程度是胰腺癌预后的独立影响因素。结论手术是日前胰腺癌治疗的唯一有效手段，随着手术方式和围手术期治疗的进步，胰腺癌的手术病死率和并发症发生率明显下降，术后生存率逐步提高。Objective To analyze the efficacy of pancreatic cancer resection and predicative factors in a single-center study. Methods Between January 2000 and December 2011, 2061 patients with adenoeareinoma of the pancreas underwent surgical treatment in Department of Surgery, Changhai hospital, and the clinical data were retrospectively analyzed, in addition, all patients who received surgery before September 2012 were followed. Results Of the 2061 patients, 1657 （80.4%） underwent radical resection, 271 （ 13.2% ） underwent palliative resection. For radical resection cases, the 1-, 3- and 5-year survival rates were 60.3%, 21.1% and 10.9%, respectively, with a median survival of 19.6 months, in which 180 patients survived more than 5 years. For palliative resection cases, the median survival was 7.2 months. The resection rate and 3-years survival increased from 75.3% and 12.4% in 2000 - 2003 to 82.5% and 22.1% in 2008 2009. Independent prognostic factors detected by Cox regression analysis were major vessels eneasement, lymph nodes metastasis, pert-neural invasion and tumor differentiation. Conclusions Surgery remains the only hope for long-term survival in patients with adenocarcinoma of the pancreas. With the development of surgical teehniques and pert-operative management, the operative mortality and complication rate for patients with pancreatic adenocarcinoma is notably decreased, and post-operative survival is significantly prolonged.

关 键 词：胰腺肿瘤 外科手术 治疗结果 预后 

分 类 号：R735.9[医药卫生—肿瘤]