进展期胰腺癌患者姑息性旁路手术治疗的预后多因素分析

Prognostic factors of palliative bypass swrgery for patients with advanced pancreatic cancer

目的探讨进展期胰腺癌患者姑息性旁路手术后的预后因素。方法选取2005年1月至2013年12月我院109例姑息性手术治疗的胰腺癌患者,研究患者年龄、肿瘤大小、肿瘤部位、淋巴结转移、KPS评分、远隔脏器转移情况、术后治疗方法、术前血清CA19-9及CEA水平等变量与预后的关系。结果本研究中所有患者总体中位生存期为8.2个月。Cox单因素及多因素分析确定KPS评分、远隔脏器转移情况、术后治疗方法、术前血清CA19-9水平是与患者预后有关的独立因素(P<0.05)。Kaplan-Meier生存曲线显示KPS评分<80分、远隔脏器转移、高血清CA19-9水平及术后未进行联合放化疗的患者生存时间较短(P<0.05)。结论 KPS评分、远隔脏器转移、术后治疗方法、术前血清CA19-9水平可作为姑息性治疗的进展期胰腺癌患者预后的重要因素。

Objective To investigate the prognostic factors of patients with advanced pancreatic cancer after palliative bypass operation. Methods The clinical data of 109 patients with advanced pancreatic cancer underwent palliative operation between Jan. 2005 and Dec. 2013 in our hospital were retrospectively analyzed. The postoperative survival status and prognostic factors were analyzed. Results The overall median survival time of these patients was 8.2 months. Cox analysis showed that the KPS score, distant organ metastasis, postoperative treatment, preoperative serum CA19-9 level were independent factors which associated with the prognosis of patients （P〈0.05）. Kaplan-Meier survival curves showed that patients which with the KPS score〈80, distant metastasis, high serum CA 19-9 level, without postoperative radiotherapy and chemotherapy had shorter overall survival time （P〈0.05）. Conclusion The KPS score, distant organ metastasis, postoperative treatment, preoperative serum CA19-9 level are prognostic factors in patients with advanced pancreatic cancer after palliative operation.