中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2008年
11期
767-769
,共3页
张维建%韩少良%蒋飞照%张启瑜%谢先海%方瑶%柯庆宏
張維建%韓少良%蔣飛照%張啟瑜%謝先海%方瑤%柯慶宏
장유건%한소량%장비조%장계유%사선해%방요%가경굉
胰腺肿瘤%胰体尾%根治性切除%切除率%生存率
胰腺腫瘤%胰體尾%根治性切除%切除率%生存率
이선종류%이체미%근치성절제%절제솔%생존솔
Pancreatic neoplasm%Body and tail of the pancreas%Radical resection%Resection rate%Survival rates
目的 探讨胰体尾癌R0(根治性)切除率的影响因素和外科疗效.方法 回顾性分析214例胰体尾癌病例的临床病理、手术资料及预后.结果 该组214例胰体尾癌中有120例接受手术治疗,手术治疗组总切除率为59.2%(71/120例),R0率为40.8%(49/120例).与其他治疗方式相比,R0切除病例的肿瘤直径小、淋巴结转移率低及周围脏器浸润率低,且Ⅰ期、Ⅱ期和Ⅲ期病例的根治切除率(分别为100%、100%和87.5%)明显高于ⅣA期(29%)和ⅣB期(0)病例(P＜0.01).该组病例总的1、3及5年生存率分别为14.5%(31/214例)、7.0%(15/214)和2.4%(5/214例),R0切除组1、3及5年生存率分别为53.1%(26/49例)、30.6%(15/49例)和10.2%(5/49),显著好于其他治疗方式病例(9.1%、0及0 vs12.2%、0及0 vs.1.2%、0及0)(P＜0.01).结论 提高胰体尾癌的切除率在于早期诊断,且根治性切除是提高肿瘤疗效的关键.
目的 探討胰體尾癌R0(根治性)切除率的影響因素和外科療效.方法 迴顧性分析214例胰體尾癌病例的臨床病理、手術資料及預後.結果 該組214例胰體尾癌中有120例接受手術治療,手術治療組總切除率為59.2%(71/120例),R0率為40.8%(49/120例).與其他治療方式相比,R0切除病例的腫瘤直徑小、淋巴結轉移率低及週圍髒器浸潤率低,且Ⅰ期、Ⅱ期和Ⅲ期病例的根治切除率(分彆為100%、100%和87.5%)明顯高于ⅣA期(29%)和ⅣB期(0)病例(P＜0.01).該組病例總的1、3及5年生存率分彆為14.5%(31/214例)、7.0%(15/214)和2.4%(5/214例),R0切除組1、3及5年生存率分彆為53.1%(26/49例)、30.6%(15/49例)和10.2%(5/49),顯著好于其他治療方式病例(9.1%、0及0 vs12.2%、0及0 vs.1.2%、0及0)(P＜0.01).結論 提高胰體尾癌的切除率在于早期診斷,且根治性切除是提高腫瘤療效的關鍵.
목적 탐토이체미암R0(근치성)절제솔적영향인소화외과료효.방법 회고성분석214례이체미암병례적림상병리、수술자료급예후.결과 해조214례이체미암중유120례접수수술치료,수술치료조총절제솔위59.2%(71/120례),R0솔위40.8%(49/120례).여기타치료방식상비,R0절제병례적종류직경소、림파결전이솔저급주위장기침윤솔저,차Ⅰ기、Ⅱ기화Ⅲ기병례적근치절제솔(분별위100%、100%화87.5%)명현고우ⅣA기(29%)화ⅣB기(0)병례(P＜0.01).해조병례총적1、3급5년생존솔분별위14.5%(31/214례)、7.0%(15/214)화2.4%(5/214례),R0절제조1、3급5년생존솔분별위53.1%(26/49례)、30.6%(15/49례)화10.2%(5/49),현저호우기타치료방식병례(9.1%、0급0 vs12.2%、0급0 vs.1.2%、0급0)(P＜0.01).결론 제고이체미암적절제솔재우조기진단,차근치성절제시제고종류료효적관건.
Objective To explore the radical (RO) resection rate and surgical outcome for the carcinoma of body and tail of the pancreas.Methods The clinical and operative data and follow-up Results of 214 patients with the carcinoma of body and tail of the pancreas were analyzed retrospectively.Results One hundred and twenty of the 214 patients with the carcinoma of body and tail of the pancreas underwent surgical treatment,the overall resection rate was 59.2% (71/120),and the R0 resection rate was 40.8% (49/120).Compared with other treatments,the patients receiving R0 resection had smaller size,lower lymph node involvement and peri-pancrcatic organ involvement.The radical resection rates for TNM stage Ⅰ ,Ⅱ and Ⅲ patients were 100%,100% and 87.5%,respectively,which were significantly higher than those in stage IV A (29% ) and IVB(0% ) (P＜ 0.01 ).Moreover,the overall 1,3 and 5-year survival rates in the total resection of the carcinoma of body and tail of the pancreas were 14.5%(31/214),7.0%(15/214) and 2.4%(5/214),respectively,which were significantly better than those in the palliative resection group (9.1%,0 and 0),bypass operarion and laparotomy group (12.2%,0 and 0) and non-surgical group (1.20%,0 and 0)(P＜0.01).Conclusions The early diagnosis of the carcinoma of body and tail of the pancreas is crucial for increase in radical resection rate.The radical resection plays an important role in the improvement of surgical treatment.
