胰腺癌切除术后远期生存的影响因素分析

胰腺癌恶性程度高,进展快,预后差,手术切除仍是目前被公认为早期和无远处转移局部进展期胰腺癌的首选治疗[1].随着现代影像诊断技术的发展和胰腺外科水平的提高,胰腺癌的切除率显著提高,术后并发症和围手术期死亡率不断下降,但胰腺癌术后的远期生存率仍很不理想,术后复发和转移率高, 5年生存率10％～20％[2].本文回顾208...

Analysis of factors in influencing long-term survival after radical resection for pancreatic cancer

Objective ToSanalyzeStheSfactorsSthat influencingStheSprognosis of patientsSwithSradical resection of pancreatic cancer and improve it .Methods The clinical ,pathological and follow-up datas of 208 patients with pancreatic cancer who underwent radical resection from January 2011 to March 2016 were retrospectively analyzed . Investigating the peri-operation factors influencing the survival of patients,especially CA199,vascular resection,tumor size,lymphatic metastasis ,margin status. Survival rate was calculated by Kaplan-Meier estimation while survival curve was analysed by Log-rank test. Prognostic factors were studied by multivariate analysis with COX proportional hazards survival model. Results In this group ,the total median survival time was 15 months. Overall survival rates at 1 years,3 years,5 years were 69.7%,20.6 % and 11.6% respectively. The incidence of postoperative complications were 21.6%, The abdominal infection was 10.1%.,The perioperative mortality was nil.Univariate analysis suggested that median survival time was related with CA199, positive resection margin, lymphatic metastasis, tumor stage ; COX multivariate analysis showed that tumor differentiation, lymphatic metastasis, positive resection margin were independent risk factors for dismal prognosis. Conclusion The improvement of early diagnosis rate and the surgery is the main way to enhance the prognosis.May be the new adjunctive therapy can prolong the survival time of patients whose preoperative imaging indicate that lymph node involvement and the highly positive resection margin.