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目的探讨Vater壶腹癌局部切除术后长期生存的相关因素,以更好地掌握其手术适应证。方法回顾性总结38例行局部切除术Vater壶腹癌患者的临床病理资料及生存状况,并进行单因素和多因素分析。结果全组无手术死亡。术后并发症5例(13.2%)。全组1,5,10年生存率分别为83.5%、51.4%和38.9%;中位生存时间3.35年,13例生存5年以上,2例生存10年以上。单因素分析结果显示,肿瘤大小、淋巴结转移、UICC分期晚和分化差是显著的预后指标。多因素分析结果显示,淋巴结转移情况是有统计学意义的独立预后指标。结论选择性壶腹癌局部切除术的并发症发生率低,生存率高,适用于直径<1cm的高分化T1期高危壶腹癌患者。
Objective To investigate the long-term survival of Vater ampullary carcinoma after partial resection related factors in order to better grasp the indications for surgery. Methods The clinical and pathological data and survival of 38 patients with Vater ampullary carcinoma were retrospectively reviewed. Univariate and multivariate analyzes were performed. Results All patients died without surgery. Postoperative complications in 5 cases (13.2%). The overall 1, 5, 10 year survival rates were 83.5%, 51.4% and 38.9%, respectively. The median survival time was 3.55 years. Thirteen patients survived for more than 5 years and 2 patients survived for more than 10 years. Univariate analysis showed that tumor size, lymph node metastasis, late UICC stage and poor differentiation were significant prognostic indicators. Multivariate analysis showed that lymph node metastasis was a statistically significant independent prognostic factor. Conclusion The selective resection of ampullary carcinoma with low incidence of complications, high survival rate, suitable for high differentiated T1 <1cm high-risk endometrial cancer patients.