论文部分内容阅读
背景众多回顾性研究以及3个随机对照试验(randomized controlled trials,RCT)均对扩大淋巴结切除的胰十二指肠切除术(pancreatoduodenectomy,PD)治疗胰腺癌的价值进行了评估,但是这3个RCT所使用的指南及所获得的结果却各有不同。因而,一项多中心的RCT研究在1998年提出并施行,旨在评估经标准或扩大淋巴结切除的根治性PD术治疗胰腺癌患者的长期生存情况、发病率、死亡率以及生活质量。方法从2000年3月至2003年5月间,共入选112例有可能治愈的胰头癌患者,手术期间随机分成标准淋巴结切除组和扩大淋巴结切除组,所有手术患者均未行其他任何辅助治疗。结果 101例有效病例可用于分析研究,两组的人口构成以及组织病理学特征均相似。扩大组的平均手术时间、术中失血以及切除淋巴结数量均大于标准组,但是其他手术参数两组并无明显差异。结论尽管该项多中心RCT研究是在严格的条件控制下施行的,但是扩大淋巴结切除的根治性PD术对于本身可切除的胰头癌患者而言并不能改善此类患者的长期预后情况,其发病率、死亡率以及生存质量与行标准淋巴结切除的根治性PD术相比并无明显差别。
Background Numerous retrospective studies and three randomized controlled trials (RCTs) evaluated the value of pancreaticoduodenectomy (PD) for the treatment of pancreatic cancer with expanded lymph node dissection. However, these three RCTs The guidelines used and the results obtained vary. Thus, a multicenter RCT study was proposed and implemented in 1998 to evaluate the long-term survival, morbidity, mortality, and quality of life of patients with pancreatic cancer treated with standard or extended lymph node dissection for radical PD. METHODS: Between March 2000 and May 2003, a total of 112 patients with potentially curable pancreatic head cancer were enrolled. They were randomly divided into standard lymph node resection group and expanded lymph node resection group during surgery. All patients underwent no other adjuvant treatment. . Results 101 valid cases were available for analysis. The demographic and histopathological features of the two groups were similar. The average operative time, intraoperative blood loss, and number of lymph nodes removed in the enlarged group were greater than those in the standard group, but there were no significant differences in other surgical parameters between the two groups. Conclusion Although the multicenter RCT study was performed under strict conditional control, radical PD with expanded lymph node dissection did not improve the long-term outcome of patients with resectable pancreatic head cancer. Morbidity, mortality, and quality of life were not significantly different from radical PD with standard lymph node dissection.