Prognostic Analysis for Carcinoma of Duodenal Papilla Treated by Pancreatoduodenectomy
|School||Xinjiang Medical University|
|Keywords||Carcinoma of Duodenal Papilla Pancreatoduodenectomy Survival time Clinicopathological factors|
Objective: With the research of the clinicopathological data of52cases, to evaluatethe prognostic factors and therapeutic strategy for carcinoma of duodenal papilla treatedby pancreatoduodenectomy(PD), to provide accordance for the evaluation of prognosis ofpapillar carcinoma of the duodenum treated by pancreatoduodenectomy. Methods:Clinicopathological data of52inpatients with carcinoma of duodenal papilla underwentpancreatoduodenectomy(PD) from January1998to June2006were retrospectivelyanalyzed, who finally diagnosed by surgery and histopathology. This series included26males and26females, with a median age of57years old (range from32to75years old).Except for preoperative serum bilirubin, CA19-9, CEA, maximum diameter of tumor,surgical time, hemorrhage of surgery, regional lymphatic metastasis, depth of infiltrationof duodenal wall, differentiation of tumor, postoperative complacations, involvement ofpancreas and postoperative chemotherapy. Statistical analysis was performed using theSPSS17.0software package. The log-rank test was used to analyze relationship betweenclinicopathological factors and survival time. Kaplan-Meier method and multivariate Coxproportional hazards model with a backward stepwise selection procedure were applied tocompare the survival curves and screen the independent prognosis factors respectively.Results: The median survival time was19months, and the over all1-,3-, and5-yearcumulative survival rate was73.1%,34.6%and26.9%, respectively. The univariateanalysis showed that the prognosis of papillar carcinoma of the duodenum treated bypancreatoduodenectomy were associated with maximum diameter of tumor, regionallymphatic metastasis, depth of infiltration of duodenal wall, involvement of pancreas,differentiation of tumor and postoperative chemotherapy(P<0.05). The multivariateanalysis indicated that regional lymphatic metastasis, involvement of pancreas andpostoperative chemotherapy were independent prognostic factors. Conclusion: Multiplefactors have effects on the prognosis of carcinoma of duodenal papilla afterpancreatoduodenectomy. Regional lymphatic metastasis, involvement of pancreas and postoperative chemotherapy are independent prognostic factors. Moreover, appropriatepostoperative chemotherapy can improve survival rate.