局部切除胰体尾联合血管切除重建治疗晚期胰腺癌的疗效分析

目的:探讨局部切除胰体尾联合血管切除重建手术治疗晚期胰腺癌的效果。方法:将2010年—2012年收治的58例胰腺体部及体尾部晚期胰腺癌患者分为观察组和对照组,观察组患者采用局部切除胰体尾联合血管切除重建手术治疗后配合化疗,对照组仅接受化疗,比较两组患者的临床治疗效果与生存情况并分析预后因素。结果:两组患者的一般资料具有可比性;与对照组比较,观察组的客观有效率(44.9%vs.6.9%)、疾病控制率(82.8%vs.55.2%)明显升高(均P0.05);半年生存率(79.3%vs.48.3%)、1年生存率(55.2%vs.17.2%)、平均生存时间(17.6个月vs.10.3个月)、总生存率和无进展生存率均明显增加(均P0.05);两组患者的不良反应发生率差异无统计学差异(P0.05);单因素分析结果显示,肿瘤分期、有无淋巴/血管转移是胰腺癌患者无进展生存的影响因素(均P0.05)。结论:对于可以采取手术治疗的晚期胰腺癌患者而言,采用局部切除胰体尾联合血管切除重建手术疗效良好,可推荐应用。

Efficacy analysis of local resection of the body and tail of the pancreas combined with vascular resection and reconstruction for advanced pancreatic cancer

Objective: To analyze the efficacy of local resection of the body and tail of the pancreas combined with vascular resection and reconstruction in treatment of advanced pancreatic cancer. Methods: Fifty-eight patients with advanced pancreatic cancer in the body and tail of the pancreas admitted from 2010 to 2012 were divided into observational group and control group. Patients in observational group underwent local resection of the body and tail of the pancreas combined with vascular resection and reconstruction plus postoperative chemotherapy, and those in control group received chemotherapy only. The treatment effects and survivals between the two groups of patients were compared, and the prognostic factors for the patients were also analyzed. Results: The general data of the two groups of patients were comparable. In observational group compared with control group, the objective response rate (44.9% vs. 6.9%) and disease control rate (82.8% vs. 55.2%) were significantly increased (both P<0.05); the half-year survival rate (79.3% vs. 48.3%), 1-year survival rate (55.2% vs. 17.2%), mean survival time (17.6 months vs. 10.3 months), overall survival rate and progression-free survival rate were all significantly improved (all P<0.05). There was no significant difference in incidence of adverse reactions between the two groups (P>0.05). Univariate analysis showed that tumor stage and presence or absence of lymph node/vessel metastasis were influential factors for progression-free survival of the patients (both P<0.05). Conclusion: For patients with advanced pancreatic cancer who are able to receive surgical treatment, local resection of the body and tail of the pancreas combined with vascular resection and reconstruction may offer better results, and it is recommended to be used.