影响胰腺导管腺癌患者术后生存的多因素分析

Multivariate analysis of survival-related factors of patients with pancreatic ductal adenocarcinoma after curative resection

  • 摘要: 目的 探讨影响胰腺导管腺癌(pancreatic ductal adenocarcinoma,PDAC)患者术后生存的因素。 方法 收集本院2006 年1月-2012年7月确诊为PDAC(Ⅰa~Ⅱb期)行手术患者的完整病历资料,回顾性分析影响患者术后生存的相关因素。 结果 共纳入307例患者,中位无病生存时间为10.1个月,1、3、5年无病生存率分别为33.2%、2.9%、0.3%。中位总生存时间为15.7个月,1、3、5年总生存率分别为64.5%、8.1%、1.6%。单因素及多因素分析显示,年龄是影响PDAC患者术后无病生存时间的独立预后因素。肿瘤最大直径、肿瘤分化程度、病理T分期、病理N分期、术前血清CA125的水平、术后是否接受辅助治疗是PDAC患者术后无病生存时间和总生存时间的独立预后影响因素。 结论 年龄、肿瘤最大直径、肿瘤分化程度、病理T分期、病理N分期、术前血清CA125的水平、术后是否接受辅助治疗是影响胰腺导管腺癌预后的重要因素,对PDAC患者术后的预后评估有较高的临床应用价值。

     

    Abstract: Objective To identify multiple survival-related factors of patients with pancreatic ductal adenocarcinoma(PDAC)undergoing curative resection. Methods Clinical data about patients with resectable PDAC admitted to Chinese PLA General Hospital from January 2006 to July 2012 were collected retrospectively, and univariate and multivariate analysis were utilized to identify the prognostic value of clinicopathological indicators in resectable PDAC. Results Three hundred and seven patients were enrolled in this study.The median disease-free survival and overall survival was 10.1 months and 15.7 months, respectively.The disease-free survival rate and overall survival rate of 1-, 3-, 5-year was 33.2%, 2.9%, 0.3% and 64.5%, 8.1%, 1.6%, respectively.According to the results of univariate and Cox multivariate analysis, age was an independent prognostic value of disease-free survival(P<0.05).Tumor size, the degree of tumor differentiation, T stage, lymph node status, preoperative CA125 level were found to be independent predictors for disease-free survival and also for overall survival. Conclusion Age, tumor size, the degree of tumor differentiation, T stage, lymph node status, preoperative CA125 level can provide useful information to estimate patients’prognosis after curative pancreatic resection due to PDAC.

     

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