肿瘤分期及不同治疗方式对胰腺癌患者生存期的影响

Effects of tumor staging and different therapeutic modes on the survival of the patients with pancreatic cancer

目的探讨影响胰腺癌患者生存期的相关因素。方法回顾性分析广州中山大学孙逸仙纪念医院、中山大学附属肿瘤防治中心、广东省人民医院共3家医院2004年至2016年间1620例确诊为胰腺癌患者的病例资料,采用寿命表法及Log-rank检验分析TNM分期、手术治疗、姑息化疗、术后辅助化疗对胰腺癌患者生存时间的影响。结果所有胰腺癌患者的中位生存期为7.15个月。TNMⅠ、Ⅱ、Ⅲ、Ⅳ期患者的中位生存期分别为12.50、10.12、9.56、5.43个月,差异有统计学意义(P=0.001)。非手术治疗患者中位生存期为6.10个月,行根治性手术患者为13.67个月,差异有统计学意义(P=0.001)。未化疗患者中位生存期为5.55个月,行姑息化疗患者为7.58个月,差异有统计学意义(P=0.001)。行单纯根治性手术患者中位生存期为12.38个月,术后行辅助化疗患者为14.50个月,差异无统计学意义(P=0.561)。结论早期诊断胰腺癌从而进行根治性手术治疗是延长患者生存期的重要举措,失去手术机会的患者行姑息性化疗可在一定程度上改善临床预后。

Original ArticleEffects of tumor staging and different therapeutic modes on the survival of the patients with pancreatic cancerXie Ruijie, Zeng Linjuan, Lian Guoda, Chen Shaojie, Li Jiajia, Chen Yinting, Chen Yanzhu, Zhang Li, Wu Lili, Liu Jianhua, Huang KaihongPublished 2018-05-20Cite as Chin J Pancreatol, 2018,18(3): 159-162. DOI: 10.3760/cma.j.issn.1674-1935.2018.03.004AbstractObjectiveTo investigate the related factors for the survival of the patients with pancreatic cancer.MethodsA total of 1 620 patients confirmed as pancreatic cancer admitted in Sun Yat-sen Memorial Hospital affiliated with Sun Yat-sen University, Tumor prevention and treatment center affiliated with Sun Yat-sen University and People′s Hospital of Guangdong Province from 2004 to 2016 were retrospectively analyzed, and the effects of TNM staging, surgical treatment, palliative chemotherapy and postoperative assisted chemotherapy on the survival of the patients with pancreatic cancer were examined by life table and Log-rank test.ResultsThe median survival time of all 1 620 cases was 7.15 months. The median survival time of TNM stage Ⅰ, Ⅱ , Ⅲ and Ⅳ was 12.50 months, 10.12 months, 9.56 months and 5.43 months, and there was statistically significant difference (P=0.001) . The median survival time of cases who did not undergo surgery was 6.10 months, which of patients who underwent radical surgery was 13.67 months, and the difference was statistically significant (P=0.001). The median survival time of cases without chemotherapy was 5.55 months, which of patients who underwent palliative chemotherapy was 7.58 months, and the difference was statistically significant (P=0.001). The median survival time of cases with pure radical surgery without chemotherapy was 12.38 months, which of patients who underwent adjuvant chemotherapy was 14.50 months, and the difference was no statistically significant (P=0.561).ConclusionsEarly diagnosis followed closely by radical surgery is the key to prolong the survival of pancreatic cancer patients. And adjuvant chemotherapy for patients who lose surgery opportunity may improve clinical prognosis to a certain extent.