李皇保 1周俊 1吴晓俊 1闵捷 1赵凤庆 1刘文 1黎亮 1于费杰 1陈帅1
作者信息
- 1. 嘉兴市第一医院 肝胆外科,浙江 嘉兴 314000
- 折叠
摘要
Abstract
Objective To explore the impact of lymph node metastasis on the prognosis of patients with pancreatic head duct adenocarcinoma after pancreatoduodenectomy. Methods The clinical and pathological data of 6 549 patients who diagnosed with pancreatic head ductal adenocarcinoma, and then undergone pancreatoduodenectomy, were extracted from Jan. 2004 to Dec. 2013 by American SEER database. The relationship between lymph node metastasis and prognosis was analyzed retrospectively. Results A total of 6549 patients were selected. The 1, 3, and 5- year cancer specific survival rates were 73%, 29% and 19%, and the median survival time was 21 months. Univariate analysis showed that gender, age, degree of differentiation, tumor size, invasion range, whether lymph node metastasis (LNM) present or not, number of lymph node metastasis (nLNM), lymph node examined (LNE), lymph node positive rate (LNR) (P<0.05) were correlated with the prognosis, regardless of race, marital status (P>0.05). Multivariate Cox regression analysis showed that gender, age, differentiation, tumor size, invasive range, whether LNM present or not, LNE, LNR were correlated with prognosis (P<0.05). The 5- year cancer specific survival rate of patients without lymph node metastasis was 31%, the median survival time was 29.7 months; and the 5- year cancer specific survival rate of lymph node metastasis patients was 14%, the median survival time was 19.1 months, the difference was statistically significant (P<0.05).If LNE < 15, the 5-year cancer specific survival was 17%, the median survival time was 20.3 months, and the lymph node metastasis rate was 62.9%; if LNE ≥15, the 5-year cancer specific survival was 20%, the median survival time was 22.0 months, and the lymph node metastasis rate was 78.0%; the difference was statistically significant (P<0.05). In the stratified analysis, no matter whether lymph node metastasis or not, the increase in the number of LNE improved prognosis significantly (P<0.05). The 5- year cancer specific survival rate decreased with the increase of LNR (P<0.05). Conclusion For patients with pancreatic head ductal carcinoma, LNM was closely correlated with prognosis. In addition, factors including LNE, LNR were independent prognosis factors for patients with pancreatic head ductal carcinoma.关键词
胰头导管腺癌/预后/淋巴结转移/癌症相关生存率Key words
pancreatic head ductal adenocarcinoma/prognosis/lymph nodes metastasis/cancer specific sur-vival rate分类
医药卫生
