Relation Between Clinicopathologic Factors and Prognosis of Pancreatic Head Cancer Following Radical Resection_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LIShi-jie ^1,2 , HUJun-hong ² , XIEYong-zheng ² , RENXue-qun ² , JIAFu-xin ³ ,  LIUJiang-wei ¹

1. Department of Hepatobiliary Surgery, Urumuqi General Hospital of Lanzhou Military Region, Urumuqi 830000, Xinjiang, China;
2. Department of General Surgery, Huaihe Hospital of Henan University, Kaifeng 475000, Henan Province, China;
3. Department of Hepatobiliary Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang 471009, Henan Province, China;

Corresponding?author：

LIUJiang-wei, Email: ljw273@sohu.Com

Keywords：

Pancreatic head cancer; Clinicopathologic factor; Prognosis

DOI：

10.7507/1007-9424.20140233

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Objective To investigate the correlation with clinicopathologic factors and prognosis in pancreatic head cancer following radical resection. Methods Thirteen-eight patients with primary pancreatic head cancer admitted into Urumuqi General Hospital of Lanzhou Military Region from January 2000 to December 2007 were treated by radical resection, the clinicopathologic factors were retrospectively analyzed, the SPSS 17.0 analysis software was used to analyze the relation between clinicopathologic factors and prognosis. Results ①The follow-up rate was 81.6%(31/38), the 1-and 2-year overall survival was 38.7% and 12.9%, respectively.②Spearman analysis showed that the distant metastasis was significantly correlated with the tumor size(r_s=0.421, P=0.008)and TNM stage(r_s=0.746, P=0.000); the lymph node metastasis was significantly correlated with TNM stage(r_s=0.543, P=0.001)and was not correlated with tumor differentiation degree(r_s=0.074, P=0.695), the tumor size was also significantly correlated with TNM stage (r_s=0.475, P=0.003).③Univariate Chi-Square test revealed that the gender(P=0.045), tumor size(P=0.004), tumor differentiation degree(P=0.003), TNM stage(P=0.000), distant metastasis(P=0.002), and lymph node metastasis(P=0.001)were correlated with the prognosis of pancreatic head cancer. However, when the interactive effects of those factors were taken into account, TNM stage(P=0.001), differentiation degree(P=0.003), and lymph node metastasis(P=0.007)were selected as the most significant prognostic factors in a multivariate analysis by using the Cox proportional hazard regression model.④The survival rate of patients with low differentiation degree was significantly shorter than that of moderate/high differentiation degree(P=0.003), of patients withⅠ+Ⅱstages was significantly longer than that ofⅢ+Ⅳstages(P=0.000), of patients with distant metastasis or lymph node metastasis was significantly lower than those patients without distant metastasis or lymph node metastasis(P=0.002, P=0.001). Conclusions The lymph node metastasis is significantly associated with TNM stage, and is not associated with differentiation degree. The lymph node metastasis, differentiation degree, and TNM stage are related with survival, and they are also independent prognostic factors of pancreatic head cancer.

Citation： LIShi-jie, HUJun-hong, XIEYong-zheng, RENXue-qun, JIAFu-xin, LIUJiang-wei. Relation Between Clinicopathologic Factors and Prognosis of Pancreatic Head Cancer Following Radical Resection. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(8): 965-970. doi: 10.7507/1007-9424.20140233 Copy

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1. Hidalgo M. Pancreatic cancer[J]. N Engl J Med, 2010, 362(17): 1605-1617.
2. van der Gaag NA, Rauws EA, van Eijck CH, et al. Preoperative biliary drainage for cancer of the head of the pancreas[J]. N Engl J Med, 2010, 362(2): 129-137.
3. Lau MK, Davila JA, Shaib YH. Incidence and survival of pancreatic head and body and tail cancers: a population-based study in the United States[J]. Pancreas, 2010, 39(4): 458-462.
4. Sakai Y, Ishihara T, Tsuyuguchi T, et al. Clinical evaluation of endosonography-guided biliary drainage for patients with the difficulty with placing of internal drainage[J]. Hepatogastroenterology, 2010, 56(96): 1596-1599.
5. 左朝暉, 歐陽永忠, 周德善, 等.胰頭癌的外科治療[J].中華腫瘤雜志, 2011, 33(12): 933-936.
6. 鐘守先.胰頭癌根治術之我見[J].中國實用外科雜志, 2004, 24(5): 262-263.
7. Massucco P, Ribero D, Sgotto E, et al. Prognostic significance of lymph node metastases in pancreatic head cancer treated with extended lymphadenectomy: not just a matter of numbers[J]. Ann Surg Oncol, 2009, 16(12): 3323-3332.
8. McKay A, Mackenzie S, Sutherland FR, et al. Meta-analysis of pancreaticojejunostomy versus pancreaticogastrostomy reconstruction after pancreaticoduodenectomy[J]. Br J Surg, 2006, 93(8): 929-936.
9. 周江蛟, 田艷濤, 劉昊, 等.胰腺癌臨床病理特征與淋巴結轉移的關系[J].中華腫瘤雜志, 2013, 35(2): 132-134.
10. Di Giorgio A, Alfieri S, Rotondi F, et al. Pancreatoduodenectomy for tumors of Vater's ampulla: report on 94 consecutive patients[J]. World J Surg, 2005, 29(4): 513-518.
11. 鄭樹森, 黃東勝, 李啟勇, 等.胰腺癌的早期診斷是提高療效的關鍵[J].中華外科雜志, 2003, 41(5): 322-323.
12. 魏曉平, 刁暢, 胡明道, 等. 165例胰頭癌的外科治療與預后分析[J].腹部外科, 2011, 24(6): 355-356.

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Relation Between Clinicopathologic Factors and Prognosis of Pancreatic Head Cancer Following Radical Resection

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