胰腺癌合并其他器官恶性肿瘤37例临床特点及生存分析

Clinical characteristics and survival analysis of 37 cases with pancreatic cancer complicated with malignant tumors in other organs

目的探讨胰腺癌合并其他器官恶性肿瘤(胰腺重复癌)的发生率、临床特点及预后情况。方法回顾性分析37例胰腺重复癌患者的临床资料,并对患者生存期进行随访。结果 37例胰腺重复癌患者占同期收治胰腺癌患者的4.5%(37/826)。其中,同时性胰腺重复癌16例,异时性胰腺重复癌21例。37例患者共发生胰腺癌以外恶性肿瘤41个,以胃、结直肠癌最多,分别占22.0%、12.2%。从发现第一肿瘤开始生存计算,37例患者的5年累积生存率为33.6%。异时性胰腺重复癌患者的预后优于同时性胰腺重复癌(P<0.01),胰腺癌发生在前和同时发生患者的预后差于胰腺癌发生在后的患者(P<0.01)。结论胰腺癌诊治过程中应密切注意胰腺重复癌的可能,胰腺癌可能是影响胰腺重复癌预后的主要原因。

Objective To investigate the incidence, clinical characteristics and prognosis of patients with pancreatic cancer complicated with malignant tumors in the other organs （pancreatic multiple primary cancers）. Methods The clinical data of 37 patients with pancreatic multiple primary cancers were retrospectively analyzed, and the survival time was followed up. Results Thirty-seven cases with pancreatic multiple primary cancers accounted for 4. 5 % of all the pancreatic cancers treated at the same time. Among them, 16 cases were the synchronous multiple primary cancers,and 21 cases were the metachronous ones. There were 41 malignant tumors occurred outside the pancreas cancer, and gastric and colorectal cancers were the most, which accounted for 22.0% and 12.2%, respectively. The survival analysis was started from the diagnosis of the first tumor, and the 5-year survival rate of all patients with follow-up was 33. 6%. The prognosis of synchronous multiple primary cancer was better than that of metachronous multiple primary cancer（P〈0. 01）. Besides,the prognosis of patients with pancreatic cancer occurred ahead or at the same time was significantly worsen than that of patients with pancreatic cancer occurred thereafter （P〈0. 01 ）. Conclusion Pancreatic multiple primary eancers should be noticed during the diagnosis and treatment of pancreatic cancer,and pancreatic cancer may be the main factor to affeet the prognostic of pancreatic multiple primary cancers.