Evaluation of Surgical Resection for Pancreatic Carcinoma at a Japanese Single Cancer Institute
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概要
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Background/Aims: Surgical resection is a radical treatment option for pancreatic carcinoma (PC); however, it is still difficult to cure and patient prognosis is poor at this stage. Methodology: We examined the demographics, surgical records and outcome in 64 patients with hilar PC undergoing surgical resection. Results: Pancreatoduodenectomy (PD) was carried out in 48 patients, distal pancreatectomy (DP) in 14 and total pancreatectomy in two. Postoperative complications were observed in 18 patients (28%) but no hospital deaths. All stage I patients showed carcinoma in situ of intraductal papillary mucinous carcinoma (IPMC). Postoperative adjuvant chemotherapy was performed in 15 patients (23%) using gemcitabine or S-1. Cancer recurrence was observed in 36 patients (56%) and 31 died of carcinoma. The 5-year cancer-free and overall survival rate was 12% and 14%, respectively. CA19-9 level, morphological type, T category, lymph node metastasis, extrapancreatic nerve plexus invasion, retropancreatic tissue invasion, distal bile duct invasion, duodenal invasion and arterial system invasion were significant poor prognostic factors; however, portal vein system invasion was not significantly associated with prognosis. Cancer infiltration at bile duct cut-end and dissected peripancreatic tissue margin and presence of residual tumor showed a poor prognosis. Surgical prognosis in only non-invasive IPMC was satisfactory.Conclusions: Radically extended surgical resection is necessary and newly effective adjuvant chemotherapy is a promising modality to improve patient survival in PC patients.
論文 | ランダム
- FD講演会実施報告 九州大学の授業評価の現状 2003年3月6日〔含 質疑応答〕
- 2001年8月10日の内閣総理大臣令「2001年3月6日の法律第64号第6条第1項の規定に基づき非軍事役務を認められる青年の割当定員の決定並びに各々の法的取扱い及び経済的待遇並びに関連する検査計画に関する規定」 (イタリアの自発的非軍事役務関連法令の概要について)
- 2001年3月6日の法律第64号「国民的非軍事役務の創設」 (イタリアの自発的非軍事役務関連法令の概要について)
- 忙中日誌(2003年2月10日〜3月6日)
- 設計 天神川の護岸改修(鳥取市) 着工の直後に設計ミスが判明 (特集 失敗の値段--手直し工事や指名停止が企業経営を揺るがす) -- (費用負担の実例)