中国实用外科杂志2017，Vol.37Issue(7)：778-783,6.DOI:10.19538/j.cjps.issn1005-2208.2017.07.20
胰腺癌根治术后病人生存相关因素分析
Factors influencing the prognosis of patients with pancreatic cancer after intended radical surgery
摘要
Abstract
Objective To analyze the factors influencing the prognosis of patients with pancreatic cancer after intended radical surgery. Methods The clinical data of 275 cases of pancreatic cancer accepted intended radical surgery in Pancreas Center of the First Affiliated Hospital of Nanjing Medical University from January 2010 to December 2013 were analyzed retrospectively. Results A total of 216 cases(78.5%)died during 18(9-36)months of follow-up. The overall median survival time was 15.1(95%CI 11.7-18.4)months. The 1-,3-,5-year survival rates were 63.2%,23.1%,11.8%, respectively. The median survival time of patients received adjuvant chemotherapy was 29.1(19.5-38.7)months. The 1-,3-,5-year survival rates were 78.6%, 43.6%, 25.4%,respectively. Cox regression model showed that preoperative serum CA19-9,differentiation of tumor,tumor size,microscopic vascular invasion,positive nodal ratio,adjuvant chemotherapy were the independent risk factors influencing the prognosis of patients with pancreatic cancer after intended resection(P<0.05). Further stratification analysis showed preoperative serum CA19-9,differentiation of tumor, tumor size,microscopic vascular invasion,adjuvant chemotherapy were the independent risk factors influencing the prognosis of patients with pancreaticoduodenectomy(P<0.05),and differentiation of tumor,positive nodal ratio, microscopic vascular invasion,adjuvant chemotherapy were the independent risk factors influencing the prognosis of patients with distal pancreatectomy. Conclusion Pancreatic cancer patients,either in the head or body-tail, with higher preoperative CA19-9, higher positive nodal ratio, and poorer tumor differentiation and microscopic vascular invasion have a worse prognosis. Adjuvant chemotherapy, which can significantly prolong patients' survival after radical resection, should be encouraged.关键词
胰腺癌/根治性切除/术后化疗/预后Key words
pancreatic cancer/radial resection/adjuvant chemotherapy/prognosis分类
医药卫生引用本文复制引用
徐冬,吕楠,蒋奎荣,苗毅,陆子鹏,郭峰,陈建敏,卫积书,尹杰,张凯,吴鹏飞,蔡宝宝..胰腺癌根治术后病人生存相关因素分析[J].中国实用外科杂志,2017,37(7):778-783,6.基金项目
国家自然科学基金青年基金(No.81300351) （No.81300351）
临床前沿技术(No.BE2016788):六大高峰人才项目(No.2014-WSW-006) （No.BE2016788）
