METHODS: Ninety-five patients who had undergone a distal pancreatectomy for resectable (R) or borderline resectable (BR) PC within the pancreatic body or tail region were retrospectively investigated and divided into four groups (three subgroups of R-PC according to tumor location, and BR-PC): R-PC in the pancreatic body region (group A, n = 24), R-PC on the right side of the pancreatic tail region (group B, n = 17), R-PC on the left side of the pancreatic tail region (group C, n = 29), and BR-PC located in any region within the pancreatic body and tail (group BR, n = 25).
RESULTS: Group C patients showed a higher incidence of pretreatment splenic artery and vein involvement than group A and B patients (splenic artery: 8.3/11.8/41.4%, p < 0.010; splenic vein: 25.0/23.5/79.3%, p < 0.010, in groups A/B/C, respectively). The overall survival of group C patients was significantly unfavorable compared to that of group A and B patients (median: 3.9/4.2/2.3 years in groups A/B/C, p = 0.029, respectively). Pretreatment clinical factors were comparable between group C and group BR. Median survival rates were comparable between group C and BR patients (2.3 and 2.0 years, respectively) (p = 0.93).
CONCLUSIONS: Differences in anatomical location within the pancreatic body and tail characterize the unfavorable outcomes of PC near the splenic hilum.
方法:对95例因胰腺体部或尾部可切除(R)或临界可切除(BR)PC行胰腺远端切除术的患者进行回顾性调查,并分为四组(根据肿瘤位置,R-PC的三个亚组,和BR-PC):胰体区的R-PC(A组,n=24),胰尾区右侧R-PC(B组,n=17),胰尾区左侧R-PC(C组,n=29),和BR-PC位于胰体和胰尾内的任何区域(BR组,n=25)。
结果:C组患者治疗前脾动脉和静脉受累的发生率高于A组和B组患者(脾动脉:8.3/11.8/41.4%,p<0.010;脾静脉:25.0/23.5/79.3%,p<0.010,在A/B/C组中,分别)。与A组和B组患者相比,C组患者的总生存期明显不利(A/B/C组的中位数:3.9/4.2/2.3年,分别为p=0.029)。C组和BR组之间的治疗前临床因素具有可比性。C组和BR组患者的中位生存率相当(2.3年和2.0年,分别)(p=0.93)。
结论:胰腺体部和尾部解剖位置的差异表征了PC在脾门附近的不利结局。