胰头癌根治性胰十二指肠切除术后肿瘤早期复发的影响因素分析

目的:探讨胰头癌根治性胰十二指肠切除术后肿瘤早期复发的影响因素。方法:采用回顾性病例对照研究方法。收集2014年5月至2015年5月复旦大学附属肿瘤医院收治104例胰头癌行根治性切除术病人的临床病理资料；男62例，女42例；年龄为（61±10）岁。病人均行根治性胰十二指肠切除术。观察指标：（1）手术情况。（2）随访情况...

Influencing factors for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer

Objective To investigate the influencing factors for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer.Methods The retrospective case-control study was conducted.The clinicopathological data of 104 patients with pancreatic head cancer who underwent radical resection in Fudan University Shanghai Cancer Center from May 2014 to May 2015 were collected.There were 62 males and 42 females,aged(61±10)years.Patients underwent carative pancreaticoduodenectomy.Observation indicators:(1)surgical situations;(2)follow-up;(3)influencing factors for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer.Follow-up was conducted using telephone interview to detect recurrence of patients up to postoperative 1 year.Measurement data with normal distribution were represented as Mean±SD.Count data were described as absolutes numbers,and comparison between groups was analyzed using the chi-square test.Multivariate analysis was analyzed using the Logistic regression model.Results(1)Surgical situations:104 patients underwent curative pancreaticoduodenec-tomy successfully.The volume of intraoperative blood loss was(474±280)mL and the number of lymph node dissection was 21±10.(2)Follow-up:104 patients received postoperative follow-up,44 of whom had early recurrence.Of the 44 patients with early recurrence,42 cases had intraperitoneal recurrence including 23 cases with liver metastasis,7 cases with metastasis in surgical site,7 cases with retroperitoneal lymph node metastasis,5 cases with omentum metastasis,2 cases had extraperitoneal recurrence including 1 case with pleural metastasis and 1 case with pulmonary metastasis.(3)Influencing factors for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer:results of univariate analysis showed levels of preoperative CA19-9,levels of postoperative CA19-9,the number of lymph node dissection were related factors for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer(χ²=5.833,9.276,4.261,P<0.05).Results of multivariate analysis showed that postoperative CA19-9>37 U/mL was an independent risk factor for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer(odd ratio=3.599,95%confidence interval as 1.551-8.347,P<0.05).Conclusion Postoperative CA19-9>37 U/mL is an independent risk factor for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer.