Pancreaticoduodenectomy for advanced gastric cancer with pancreaticoduodenal region involvement
Pancreaticoduodenectomy for advanced gastric cancer with pancreaticoduodenal region involvement作者机构：Department of Hepato-Biliary- Pancreatico-Gastric Surgery Zhejiang Cancer Hospital Hangzhou 310022 Zhejiang Province China
出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)
年 卷 期：2008年第14卷第21期
页 面：3425-3429页
核心收录：
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Pancreaticoduodenectomy Gastric cancer Gastrectomy Predictive factor Patients
摘 要：AIM：To characterize the factors of the improved survival following combined pancreaticoduodenectomy（PD） and gastrectomy for the treatment of advanced gastric cancer with pancreaticoduodenal region involvement. METHODS：From 1995 to 2004,53 patients with primary gastric cancer were diagnosed with synchronous（n = 44） or metachronous（n = 9） pancreaticoduodenal region *** these,17 patients（32%） underwent total gastrectomy（TG） or distal subtotal gastrectomy（SG） combined with PD *** preoperative demographic,clinical information,clinicopathologic features and the surgical results of these 17 patients were considered as factors influencing survival and were analyzed by the Kaplan-Meier method with log-rank comparison. RESULTS：The actual 1-and 3-year survival rates of these 17 patients after resection were 77% and 34%,respectively,and three patients survived for more than 5 years after *** tumor-free resection margin（P = 0.0174） and a well-differentiated histologic type（P = 0.0011） were significant prognostic factors on univariate *** mortality occurred within one mo after operation,postoperative weight loss of different degree was present in all the patients with TG and 12 cases had other *** were 9（53%） cases of recurrence in 5-48 mo after *** survival rate in the palliative and explorative group was significantly（P = 0.0064） lower than in the combined PD group. CONCLUSION： Judicious use of en bloc PD and gastrectomy and strictly preventing postoperative complications may improve the long-term survival for advanced gastric cancer patients with pancreaticoduodenal region involvement. Well-differentiated histology and negative resection margin are the most important predictors of long survival.
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