Impact of lymph node involvement on long-term survival after R0 pancreaticoduodenectomy for ductal adenocarcinoma of the pancreas

被引:73
作者
Zacharias, Thomas
Jaeck, Daniel
Oussoultzoglou, Elie
Neuville, Agnes
Bachellier, Philippe
机构
[1] Univ Strasbourg, Hop Univ Strasbourg, Hop Hautepierre, Ctr Chirurg Viscerale & Transplantat, F-67098 Strasbourg, France
[2] Univ Strasbourg, Hop Univ Strasbourg, Hop Hautepierre, Serv Pathol, F-67098 Strasbourg, France
关键词
adenocarcinoma; pancreaticoduodenectomy; lymph node;
D O I
10.1007/s11605-007-0113-3
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Pancreaticoduodenectomy remains the only potentially curative treatment for adenocarcinoma of the pancreas. The aim of this study was to analyze prognostic factors impacting survival after R0 pancreaticoduodenectomy for adenocarcinoma in the head of the pancreas. Between 1995 and 2002, a potentially curative (R0) pancreaticoduodenectomy with pancreatogastrostomy for ductal adenocarcinoma in the head of the pancreas was performed in 81 patients (42 women and 39 men) with a mean age of 64 years (range 35-84). Patients were identified from a prospective database and records were reviewed retrospectively. Postoperative mortality was 1%, and 40% of patients had complications. Median survival was IS months, and the 5-year survival was 24%. Fifteen patients were alive it 5 years. Factors associated with poor survival in multivariate analysis were (1) two or more positive lymph nodes, (2) tumor diameter greater than 30 turn, and (3) age greater than 70 years. In patients with no or with one positive lymph node, the 5-year survival was 44%. On the other hand, in patients with two or more positive lymph nodes, both the 3- and 5-year survival was 5%. The main risk factor associated with poor survival after an R0 pancreaticoduodenectomy for adenocarcinoma in the head of pancreas was lymph node status: The presence of two or more positive lymph nodes was associated with decreased survival.
引用
收藏
页码:350 / 356
页数:7
相关论文
共 32 条
[11]   Who benefits from portal vein resection during pancreaticoduodenectomy for pancreatic cancer? [J].
Launois, B ;
Stasik, C ;
Bardaxoglou, E ;
Meunier, B ;
Campion, JP ;
Greco, L ;
Sutherland, F .
WORLD JOURNAL OF SURGERY, 1999, 23 (09) :926-929
[12]   Influence of postoperative morbidity on long-term survival following liver resection for colorectal metastases [J].
Laurent, C ;
Cunha, AS ;
Couderc, P ;
Rullier, E ;
Saric, J .
BRITISH JOURNAL OF SURGERY, 2003, 90 (09) :1131-1136
[13]   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
[14]   Prognostic factors following curative resection for pancreatic adenocarcinoma - A population-based, linked database analysis of 396 patients [J].
Lim, JE ;
Chien, MW ;
Earle, CC .
ANNALS OF SURGERY, 2003, 237 (01) :74-85
[15]   Impact of anastomotic leakage on long-term survival of patients undergoing curative resection for colorectal cancer [J].
McArdle, CS ;
McMillan, DC ;
Hole, DJ .
BRITISH JOURNAL OF SURGERY, 2005, 92 (09) :1150-1154
[16]   Long-term survival in pancreatic cancer: Pylorus-preserving versus Whipple pancreatoduodenectomy [J].
Mosca, F ;
Giulianotti, PC ;
Balestracci, T ;
DiCandio, G ;
Pietrabissa, A ;
Sbrana, F ;
Rossi, G .
SURGERY, 1997, 122 (03) :553-566
[17]  
Nakano H, 2002, HEPATO-GASTROENTEROL, V49, P258
[18]   CLINICAL-SIGNIFICANCE OF PORTAL INVASION BY PANCREATIC HEAD CARCINOMA [J].
NAKAO, A ;
HARADA, A ;
NONAMI, T ;
KANEKO, T ;
INOUE, S ;
TAKAGI, H .
SURGERY, 1995, 117 (01) :50-55
[19]   Pancreaticogastrostomy decreased relaparotomy caused by pancreatic fistula after pancreaticoduodenectomy compared with pancreaticojejunostomy [J].
Oussoultzoglou, E ;
Bachellier, P ;
Bigourdan, JM ;
Weber, JC ;
Nakano, H ;
Jaeck, D .
ARCHIVES OF SURGERY, 2004, 139 (03) :327-335
[20]   Standard versus extended lymphadenectomy associated with pancreatoduodenectomy in the surgical treatment of adenocarcinoma of the head of the pancreas -: A multicenter, prospective, randomized study [J].
Pedrazzoli, S ;
DiCarlo, V ;
Dionigi, R ;
Mosca, F ;
Pederzoli, P ;
Pasquali, C ;
Klöppel, G ;
Dhaene, K ;
Michelassi, F .
ANNALS OF SURGERY, 1998, 228 (04) :508-514