Analysis Of Relationship Between Clinical Characteristics And Prognosis Of121Patients With Pancreatic Carcinoma

ObjectiveTo evaluate the influence of various clinical factors(including clinical, pathologic characteristics and mode of treatment)on the prognosis of patients with pancreatic carcinoma.MethodsPatients with pancreatic cancer were selected from the Center for Pancreatic Cancer, Cancer institute&hospital, Chinese Academy of Medical Sciences from Jan.2008to Jan.2010, all the clinical materials were analyzed retrospectively, including age, sex, initial symptoms, tumor location, surgical approach, clinical stage and so on. All the cases were followed up until March2012by way of telephone, mailand home, and were followed up121cases.121patients with complete clinical material were enrolled in this retrospective study for purpose of prognosis analysis. All the factors(including clinical, pathologic characteristics and mode of treatment) were studied by statistical method of univariate (Kaplan-Meier) and multivariate(Cox’S model)analysis. Survival rate was calcntated by Kaplan-meier method, P<0.05for significant difference.ResultsFactors potentially impacting prognosis included age, sex, the first symptom、family history of cancer, diabetes history, the preoperative level of CEA and CA19-9, tumor location, tumor size, pathological type, tumor clinical stage, peripancreatic invasion (organs, major vessels), distant metastasis, and mode of treatment. Peripancreafic invasion (Organs, major vessels), distant metastasis, clinical stage, the preoperative level of CEA and CA19-9, the first symptom and treatment were significantly correlated with survival by univariate analysis. However, the age, sex, family history of cancer, diabetes history, size, location and pathological type of tumor were not significantly correlated with prognosis.Patients with pancreatic cancer was founded by the physical examination have the longest median survival time after treatment; To accept a variety of treatment methods in patients with pancreatic cancer, median survival time was the longest in patients with radical resection, followed by intraoperative radiotherapy patients.Tumor peripancreatic invasion was identified as the most important prognostic factor by multivariate analysis. For the patients in TNM stage I1-year survival rate was41.7%, much higher than that of patients in stage Ⅱ,Ⅲ,Ⅳ(28.6%,27.5%,13.6%, respectively). In all treatment medthods, only radical resection have a3-year survival rate, it is7.5%.conclusions:1. Tumor peripancreatic invasion was the most important prognostic factor by multivariate analysis.2. We must be pay attention to the first symptom of pancreatic cancer patients, non-specific early clinical symptoms should be alerted. Regular medical examinations of high-risk groups, is helpful to the early diagnosis of pancreatic cancer. The early diagnosis of pancreatic cancer and radical resection were the most effective measure for improvement of survival rate.3. The unresectable pancreatic cancer patients accept intraoperative radiation therapy could improve the median survival time and improve the quality of life. Radiotherapy and chemotherapy alone can not improve the survival rate of patients with pancreatic cancer.4. Pancreatic cancer tumor marker CA19-9and CEA can be used as a tool for diagnosis of pancreatic cancer, The Positive Rate of CA19-9is higher than CEA, and they have an important value to judge the prognosis.