Background

Pancreatic ductal adenocarcinoma (PDAC) has the worst prognosis of all malignant tumors due to unavailable screening methods, late diagnosis with a low proportion of resectable tumors and resistance to systemic treatment. Complete tumor resection remains the cornerstone of modern multimodal strategies aiming at long-term survival. This study was performed to investigate the overall rate of long-term survival (LTS) and its contributing factors.

Methods

This was a retrospective single-center analysis of consecutive patients undergoing pancreaticoduodenectomy (PD) for PDAC between 2007 and 2014 at the St. Josef Hospital, Ruhr University Bochum, Germany. Clinical and laboratory parameters were assessed and evaluated for prediction of LTS with Cox regression analysis.

Results

The overall rate of LTS after PD for PDAC was 20.4% (34/167). Median survival was 24 months regardless of adjuvant treatment. Carbohydrate antigen 19-9 levels, tumor grade, lymph vessel invasion, perineural invasion and reduced general condition were significantly associated with LTS in univariate analysis (P < 0.05). Serum levels of carbohydrate antigen 19-9, American Joint Committee on Cancer stage, tumor grade, abdominal pain, male, exocrine pancreatic insufficiency and duration of postoperative hospital stay were independent predictors of cancer survival in multivariable analysis.

Conclusions

Cancer related characteristics are associated with LTS in multimodally treated patients after curative PDAC surgery.

中文翻译：

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胰头导管腺癌患者胰十二指肠切除术后的长期生存

背景

胰腺导管腺癌（PDAC）由于筛查方法不可用、诊断较晚、可切除肿瘤比例低以及对全身治疗的抵抗力，在所有恶性肿瘤中预后最差。完全切除肿瘤仍然是旨在长期生存的现代多模式策略的基石。本研究旨在调查长期生存 (LTS) 的总体率及其影响因素。

方法

这是对 2007 年至 2014 年间在德国波鸿鲁尔大学圣约瑟夫医院接受 PDAC 胰十二指肠切除术 (PD) 的连续患者的回顾性单中心分析。使用 Cox 回归分析评估和评估临床和实验室参数以预测 LTS。

结果

PDAC PD 后 LTS 的总体发生率为 20.4% (34/167)。无论辅助治疗如何，中位生存期为 24 个月。单因素分析显示，糖类抗原19-9水平、肿瘤分级、淋巴管侵犯、神经周围侵犯和一般情况降低与LTS显着相关（P < 0.05）。在多变量分析中，美国癌症联合委员会分期、肿瘤分级、腹痛、男性、胰腺外分泌功能不全和术后住院时间的血清碳水化合物抗原 19-9 水平是癌症生存的独立预测因素。

结论

癌症相关特征与治愈性 PDAC 手术后多模式治疗患者的 LTS 相关。