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首页> 外文期刊>Journal of Surgical Oncology >Factors influencing survival in patients undergoing palliative bypass for pancreatic adenocarcinoma
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Factors influencing survival in patients undergoing palliative bypass for pancreatic adenocarcinoma

机译：影响胰腺癌姑息旁路手术患者生存率的因素

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Purpose: The purpose of this study is to identify factors predictive of early mortality following palliative bypass in patients with previously unsuspected advanced pancreatic adenocarcinoma to provide a basis for the selection of appropriate therapies. Methods: All patients with pancreatic adenocarcinoma who underwent a bypass procedure at our institution between 9/30/1994 and 1/31/2006 were reviewed. Patients with peri-operative mortality were excluded from the analysis. Univariate analysis was performed on perioperative data to identify factors associated with early mortality (death within 6 months of surgery). Patients having multiple risk factors were assigned an overall prognostic score based on the sum of these factors. Results: Of the 397 patients with pancreatic adenocarcinoma analyzed, four factors were found to predict early mortality following palliative bypass: Presence of distant metastatic disease (HR 2.59, P < 0.0001), poor tumor differentiation (HR 1.71, P = 0.009), severe pre-operative nausea and vomiting (HR 1.48, P = 0.013), and lack of previous placement of a biliary stent (HR 1.36, P = 0.048). Patients with a prognostic score of 0 were significantly more likely to survive past 6 months than patients with a prognostic score of 1 (HR 2.71, P < 0.0001), 2 (HR 3.70, P < 0.0001), or ≥3 (HR 5.63, P < 0.0001). Conclusions: In a cohort of patients undergoing a palliative bypass procedure, specific peri-operative factors can be used to identify patients who are at risk of early mortality. These factors may be helpful in selecting appropriate interventions for this group of patients.
机译：目的：本研究的目的是确定可预测先前未曾怀疑的晚期胰腺腺癌患者姑息性旁路术后早期死亡的因素，为选择合适的治疗方法提供基础。方法：对1994年9月30日至2006年1月31日在我院接受旁路手术的所有胰腺腺癌患者进行回顾。具有围手术期死亡率的患者被排除在分析之外。对围手术期数据进行单因素分析，以确定与早期死亡率（手术后6个月内死亡）相关的因素。根据这些因素的总和，为具有多种危险因素的患者分配总体预后评分。结果：在分析的397例胰腺腺癌患者中，发现有四个因素可预测姑息旁路术后的早期死亡率：远处转移性疾病（HR 2.59，P <0.0001），肿瘤分化不良（HR 1.71，P = 0.009），严重术前恶心和呕吐（HR 1.48，P = 0.013），并且以前没有放置胆管支架（HR 1.36，P = 0.048）。预后评分为0的患者比预后评分为1（HR 2.71，P <0.0001），2（HR 3.70，P <0.0001）或≥3（HR 5.63， P <0.0001）。结论：在一组接受姑息性旁路手术的患者中，特定的围手术期因素可用于识别处于早期死亡风险的患者。这些因素可能有助于为该组患者选择适当的干预措施。

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