한국인 췌관선암의 수술적 치료결과 분석 -4개 대학병원 합동 조사 결과-

Abstract

PURPOSE: Despite the many advances in medical diagnosis and treatment, the prognosis of a pancreatic ductal adenocarcinoma is still poor. The objectives of this study were to evaluate the clinical results of a pancreatectomy for treating pancreatic cancer in Korea, and investigate whether or not there was an improvement in the survival rate over time. METHODS: From 1990 to 2002, 4278 patients with pancreatic cancer from 4 hospitals (Seoul National University Hospital, Samsung Medical Center, Asan Medical Center, Severance Hospital) were enrolled in this study. We retrospectively reviewed the clinico-pathological data of the 566 patients who underwent surgical resection and analyzed clinical results according to the time intervals (1990~1996 vs. 1997~2002). RESULTS: The median survival rate of the patients underwent a resection was 14.1 months with 14.3% of 5 year survival rate (5 YSR). Univariate analysis showed that the tumor size, the depth of invasion, lymph node metastasis, AJCC stage, portal vein resection, and adjuvant chemotherapy were the prognostic factors. Multivariate analysis showed that the tumor size, lymph node metastasis, and adjuvant chemotherapy were significant. There was a survival difference according to the time interval (11.0 vs. 15.4% in 5 YSR). A small tumor size and a low AJCC as well as active adjuvant therapy affected this survival increment. CONCLUSION: There was a slightly higher survival rate of pancreatic cancer after resection recently. This was mainly due to the early diagnosis and adjuvant therapy. Although pancreatic cancer is still lethal, progress in new systemic treatment and early detection method shows promise in the management of pancreatic cancer.