Systemic inflammatory response predicts outcome in patients undergoing resection for ductal adenocarcinoma head of pancreas

被引:128
作者
Jamieson, NB
Glen, P
McMillan, DC [1 ]
McKay, CJ
Foulis, AK
Carter, R
Imrie, CW
机构
[1] Royal Infirm, Univ Dept Surg, Glasgow G31 2ER, Lanark, Scotland
[2] Royal Infirm, Dept Pathol, Glasgow G31 2ER, Lanark, Scotland
关键词
pancreatic cancer; curative resection; tumour size; C-reactive protein; survival;
D O I
10.1038/sj.bjc.6602305
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The aim of the present study was to examine the relationship between the clinicopathological status, the pre- and postoperative systemic inflammatory response and survival in patients undergoing potentially curative resection for ductal adenocarcinoma of the head of the pancreas. Patients ( n = 65) who underwent resection of ductal adenocarcinoma of the head of pancreas between 1993 and 2001, and had pre- and postoperative measurements of C-reactive protein, were included in the study. The majority of patients had stage III disease ( International Union Against Cancer Criteria, IUCC), positive circumferential margin involvement (R-1), tumour size greater than 25 mm with perineural and lymph node invasion and died within the follow-up period. On multivariate analysis, tumour size ( hazard ratio (HR) 2.10, 95% confidence interval (CI) 1.20 - 3.68, P = 0.009), vascular invasion (HR 2.58, 95% CI 1.48 - 4.50, P<0.001) and postoperative C-reactive protein ( HR 2.00, 95% CI 1.14 - 3.52, P = 0.015) retained independent significance. Those patients with a postoperative C-reactive protein <= 10 mg l(-1) had a median survival of 21.5 months compared with 8.4 months in those patients with a C-reactive protein 410 mg l(-1) (P<0.001). The results of the present study indicate that, in patients who have undergone potentially curative resection for ductal adenocarcinoma of the head of pancreas, the presence of a systemic inflammatory response predicts poor outcome.
引用
收藏
页码:21 / 23
页数:3
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