A Clinical Analysis About The Influence Of Surgical Treatment To The Prognosis Of Pancreatic Cancer Patients With Liver Metastasis

Objective: Clinically analyzing the influence of surgical treatment and clinical characteristics to the prognosis of the pancreatic cancer patients with liver metastasis to explore the prognostic influence factors,lastly providing clinical theoretical support for the treatment of pancreatic cancer with liver metastasis.Methods: Retrospective analysis was adopted in this study.The objects of this study were the pancreatic cancer patients with liver metastasis,who were treated in the General Surgery of Shengjing Hospital affiliated to China Medical University from January 2013 to December 2017.And all the objects must meet the inclusion and exclusion criteria.Comprehensively analyzing and evaluating the influence of surgical treatment and their clinical characteristics to the prognosis of pancreatic cancer patients with liver metastasis by SPSS 19.0 software,including gender,age,first symptom,weight loss,diabetes,hepatitis,family history of cancer,preoperative Child-Pugh level of liver function,transaminase,CEA,CA 19-9,the location of pancreatic cancer,the size of pancreatic cancer,vascular invasion of pancreatic cancer,the number of liver metastasis,the size of liver metastasis and extra-hepatic metastasis.Kaplain-Meier was used to conduct univariate analysis;While COX proportional hazard regression model was used to conduct multi-factor analysis.Results: The result of univariate analysis: When P<0.05 was thought with significant statistical difference,surgical treatment,age and the size of liver metastasis were closely related to the prognosis of pancreatic cancer with liver metastasis.Considering that the cases were limited and the clinical data was complex,P<0.1 was assumed to have clinical significance.Under that assumption,vascular invasion of pancreatic cancer and extra-hepatic metastasis were analyzed to be related to the prognosis of pancreatic cancer with liver metastasis.However,gender,first symptom,weight loss,diabetes,hepatitis,family history of cancer,preoperative Child-Pugh level of liver function,transaminase,CEA,CA 19-9,the location of pancreatic cancer,the size of pancreatic cancer and the number of liver metastasis were not related to the prognosis(P>0.1).The result of multi-factor analysis: Surgical treatment and age were closely related to the prognosis of pancreatic cancer with liver metastasis.The median survival time(MST)of the patients in the group of radical operation was 144 days,in the group of palliative surgery group(gastroenterostomy group,choledochojejunostomy group)was 106 days,in the group of nervi splanchnicus major cutting-off was 96 days,in the group of exploratory laparotomy was 62 days and in the group of giving-up was 60 days(P<0.05).The MST of the patients in the group of age?45 was 93 days,in the group of 45<age?60 was 105 days and in the group of age>60 was 62 days(P<0.05).Conclusion: 1.surgical treatment and age were the most important prognostic influence factors.Radical operation may improve the prognosis for some appropriate pancreatic cancer patients with liver metastasis.In addition,early detection,early diagnosis and early treatment could obviously improve the prognosis.The prognosis of the patients with age?60 was significantly better than the patients with age>60.2.The size of liver metastasis,vascular invasion of pancreatic cancer and extra-hepatic metastasis were also related to the prognosis of pancreatic cancer with liver metastasis.For patients with diameter of the liver metastasis more than 5cm or with vascular invasion of pancreatic cancer or with extra-hepatic metastasis,the prognosis might be worse.