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.