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目的:探讨影响Vater壶腹癌行局部切除术后长期生存的相关因素,从而制订出更具针对性的治疗方案。方法:回顾性分析行局部切除术的21例Vater壶腹癌患者的临床资料,采用Kaplan-Meier法进行生存分析,独立样本t检验、Fisher精确检验。结果:全组无手术死亡,总的5年生存率为34.1%;15例患者术后出现明确的肿瘤复发和转移,其中10例患者(47.6%)出现局部复发,4例患者(19.0%)出现肝转移,1例患者(4.8%)出现腹壁转移;单因素分析表明,肿瘤直径、肿瘤分化程度是影响Vater壶腹癌患者术后生存时间的相关因素(P=0.014,0.015)。结论:Vater壶腹癌行局部切除术后预后良好,肿瘤直径和肿瘤分化程度是影响预后的相关因素,该术式适用于肿瘤直径<2cm、高分化、T1和T2期患者。
Objective: To explore the related factors that affect the long-term survival of Vater’s perineural carcinoma after local resection, so as to make a more targeted treatment plan. Methods: The clinical data of 21 cases of Vater ampulla carcinoma were retrospectively analyzed. Survival analysis, independent sample t-test and Fisher’s exact test were performed by Kaplan-Meier method. Results: The total 5-year survival rate was 34.1% in the whole group. Clear recurrence and metastasis were found in 15 patients, of which 10 (47.6%) had local recurrence and 4 (19.0% One patient (4.8%) had abdominal wall metastasis. Univariate analysis showed that the diameter of tumor and the degree of tumor differentiation were the factors affecting the survival time of patients with Vater ampullary carcinoma (P = 0.014,0.015). Conclusions: The prognosis of Vater ampullary carcinoma after local resection is good. The diameter of the tumor and the degree of tumor differentiation are the related factors that affect the prognosis. The technique is suitable for the patients with well differentiated tumors with diameter <2 cm and T1 and T2.