[Clinical analysis of 2340 cases of pancreatic cancer].

Abstract

To investigate the factors related to curable resection of pancreatic cancer and to obtain better efficacy. A uniform questionnaire survey on the clinical epidemiology of pancreatic cancer was conducted by the Society of Pancreatic Cancer, Chinese Anti-cancer Association from January 1, 1990 to December 31, 2000 on a total of 2340 the patients with pancreatic cancer confirmed clinically or pathologically in 14 hospitals in China. Survival analysis was conducted for selected patients with complete data. Cox regression was used to screen out single and multiple risk factors. Cumulative survival rate was calculated by life table and Gehan score test. Cox single factor analysis showed that the significant variables at alpha = 0.05 level included age, occupation, duration of disease, location of neoplasm, operation type, postoperative pancreatic fistula, postoperative hepatic failure, chemotherapy, TNM stage, immunotherapy, liver metastasis, and invasion of the superior mesenteric vessel. Cox multifactor analysis revealed that the significant variables at alpha = 0.05 level included age, surgical procedures, postoperative pancreatic fistula, postoperative hepatic failure, chemotherapy, and immunotherapy. These were independent factors for the prognosis of patients with pancreatic carcinoma. Among these factors, age less than 70 years, radical operation, chemotherapy and immunotherapy were all protective factors. 92.9% of the patients were aged more than 40 years, and only 7.09% were less than 40 years. The median survival time of patients after radical resection of carcinoma of the pancreatic head was 17.11 months and the 1-year survival rate was 54.36%. The 3 and 5-year survival rates were 13.47% and 8.47%. For early diagnosis, an effective way to screen population older than 40 years is really an effective way to detect patients early and promptly. And comprehensive therapy is conducive to better quality of life and longer survival time.