The analysis of resectability and survival in pancreatic cancer patients with vascular invasion

被引:24
作者
Park, DI
Lee, JK [1 ]
Kim, JE
Hyun, JG
Shim, SG
Lee, KT
Palk, SW
Rhee, JC
Choi, KW
Lim, JH
Kim, YI
机构
[1] Sungkyunkwan Univ, Dept Gastroenterol, Sch Med, Samsung Med Ctr,Kangnam Gu, 50 Ilwon Dong, Seoul 13010, South Korea
[2] Sungkyunkwan Univ, Dept Radiol, Sch Med, Samsung Med Ctr,Kangnam Gu, Seoul 13010, South Korea
[3] Sungkyunkwan Univ, Dept Surg, Sch Med, Samsung Med Ctr,Kangnam Gu, Seoul 13010, South Korea
关键词
pancreatic cancer; vascular invasion; spiral CT; resectability; survival;
D O I
10.1097/00004836-200103000-00011
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
One of the major limitations of curative resection in patients with pancreatic cancer is local tumor extension to the mesenteric vessels. Thus, the purposes of our study were to assess the clinical value of contrast-enhanced spiral computed tomography (CT) in predicting the resectability and survival of patients with pancreatic cancer with suspicious vascular invasion anti to assess the influence of curative resection on the survival of these patients. We enrolled -1 D patients with pancreatic cancer who were suspected of having an involvement of the adjacent large vessels and who subsequently underwent operation with curative intent in the study. Resectability and survival were correlated with CT findings such as segment length, degree of encasement, and type and number of vessels involved. The survival rate was compared between the curative and palliative resection groups, and survival rate was compared between the resected and unresected groups. Of the 40 patients with adenocarcinoma of the pancreas, 14 had curative resections and 26 had palliative resections, The probability of curative resection was higher in patients with segment lengths less than 2 cm, as compared with segment lengths more than 2 cm. However, there was no difference in survival between the two groups. There were no differences in resectability and survival according to the degree of encasement and type and number of vessels involved. There was no difference in survival between the curative and palliative resection groups. There was no difference in survival between the resected and unresected groups. A survival benefit was not achieved by curative resection in patients with pancreatic cancer with vascular invasion. Therefore, it would be better to avoid aggressive surgery in patients with pancreatic cancer with vascular invasion.
引用
收藏
页码:231 / 234
页数:4
相关论文
共 21 条
[1]   COST-BENEFIT-ANALYSIS OF THE WORK-UP FOR PANCREATIC-CANCER [J].
ALVAREZ, C ;
LIVINGSTON, EH ;
ASHLEY, SW ;
SCHWARZ, M ;
REBER, HA .
AMERICAN JOURNAL OF SURGERY, 1993, 165 (01) :53-60
[2]   Detection of mutant K-ras in dissected paraaortic lymph nodes of patients with pancreatic adenocarcinoma [J].
Ando, N ;
Nakao, A ;
Nomoto, S ;
Takeda, S ;
Kaneko, T ;
Kurokawa, T ;
Nonami, T ;
Takagi, H .
PANCREAS, 1997, 15 (04) :374-378
[3]   A comparison of two injection protocols using helical and dynamic acquisitions in CT examinations of the pancreas [J].
Bonaldi, VM ;
Bret, PM ;
Atri, M ;
Garcia, P ;
Reinhold, C .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1996, 167 (01) :49-55
[4]   DETECTION OF EPITHELIAL CANCER-CELLS IN PERIPHERAL-BLOOD BY REVERSE-TRANSCRIPTASE POLYMERASE CHAIN-REACTION [J].
BURCHILL, SA ;
BRADBURY, MF ;
PITTMAN, K ;
SOUTHGATE, J ;
SMITH, B ;
SELBY, P .
BRITISH JOURNAL OF CANCER, 1995, 71 (02) :278-281
[5]   Detection of colonic cells in peripheral blood of colorectal cancer patients by means of reverse transcriptase and polymerase chain reaction [J].
Castells, A ;
Boix, L ;
Bessa, X ;
Gargallo, L ;
Piqué, JM .
BRITISH JOURNAL OF CANCER, 1998, 78 (10) :1368-1372
[6]   PANCREATIC DUCTAL ADENOCARCINOMA - DIAGNOSIS AND STAGING WITH DYNAMIC CT [J].
FREENY, PC ;
MARKS, WM ;
RYAN, JA ;
TRAVERSO, LW .
RADIOLOGY, 1988, 166 (01) :125-133
[7]  
GEER RJ, 1933, AM J SURG, V163, P68
[8]   Pancreaticoduodenectomy - Does it have a role in the palliation of pancreatic cancer? [J].
Lillemoe, KD ;
Cameron, JL ;
Yeo, CJ ;
Sohn, TA ;
Nakeeb, A ;
Sauter, PK ;
Hruban, RH ;
Abrams, RA ;
Pitt, HA .
ANNALS OF SURGERY, 1996, 223 (06) :718-725
[9]   Local staging of pancreatic cancer: Criteria for unresectability of major vessels as revealed by pancreatic-phase, thin-section helical CT [J].
Lu, DSK ;
Reber, HA ;
Krasny, RM ;
Kadell, BM ;
Sayre, J .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1997, 168 (06) :1439-1443
[10]  
Lygidakis NJ, 1996, HEPATO-GASTROENTEROL, V43, P1327