52例胰体尾癌的外科诊治分析

  目的  探讨胰体尾癌的诊断与临床治疗。  方法  回顾性分析天津医科大学附属肿瘤医院从2008年1月至2012年12月收治的52例胰体尾癌患者的临床资料, 包括诊断、治疗等。应用Kaplan-Meier方法计算中位生存期。Log-rank检验分析临床病理参数对预后的影响。  结果  38例行手术探查, 手术切除24例, 基本术式为胰体尾及脾切除术; 胰腺癌TNM分期: Ⅰ期5例（13.16%）, Ⅱ期19例（50%）, Ⅲ期5例（13.16%）, Ⅳ期9例（23.67%）; 根治术后胰体尾癌的中位生存时间为（18.0±1.23）个月, 接受姑息治疗、辅助治疗及无特殊治疗患者的中位生存时间为（10.0±2.71）个月。根治性切除者生存期明显长于非根治性切除者（P < 0.01）。  结论  早期诊断是获得长期生存的关键因素, 根治性切除是提高外科治疗效果的重要环节。 

Diagnosis and surgical treatment of 52 patients with pancreatic body and tail carcinoma

  Objective  The present study discussed the clinical diagnosis and treatment of pancreatic body and tail carcinoma.  Methods  The data of 52 patients with pancreatic body and tail carcinoma treated in Tianjin Medical University Cancer Institute and Hospital from January 2008 to December 2012 were reviewed retrospectively. The data included historical materials of perioperative examination and therapy. The data of 49 cases were reviewed retrospectively, and the median survival was calculated by the Kaplan-MeiermethodThe effects of the clinicopathologic parameters on the prognosis of patients with pancreatic body and tail carcinoma were examined by the log rank test.  Results  Thirty-eight patients underwent exploratory surgery among which 24 had surgical resection, and the standard procedure was distal pancreatectomy plus splenectomy. The tumor staging was stage I in five patients (13.16%), stage Ⅱ in nineteen patients (50%), stage Ⅲ in five patients (13.16%), and stage IV in nine patients (23.67%). The median survival time was 18.0 ±1.23 months for patients who received radical resection and 10.0 ±2.71 months for patients who underwent nonspecific treatment or palliative therapy. The radical resection was associated with a longer survival period than the nonspecific treatment or palliative therapy (P < 0.01).  Conclusion  Early diagnosis is the key to achieving long-term survival. The radical resection plays an important role in improving the surgical treatment.