췌장암의 임상적 고찰 -생존율 및 예후관련인자를 중심으로-

Abstract

To identify the clinical characteristics and those factors associated with prognosis, we ana- lyzed 179 patients with pancreatic cancer who were histologically confirmed from January 1981 to August 1990 at Severance Hospital, Yonsei University. The mean age of the patients was 56.3 years, and the male to female ratio was 2.6 to 1. The most common symptom was abdominal pain(87.7%) and sign abdominal tenderness(63.7%). The elevation of serum CEA (more than 5ng/ml) was noted in 67.2%. The diagnostic accuracies for the pancreatic carci- noma of abdominal ultrasonography, computed tomography and ERCP were 86.7%, 94.3% and 92.4% respectively. The head of pancreas was the most common location(64.3% ), tail(17.9 body(15.6%), and diffuse type(2.2%) were in next order of frequency. Adeno- carcinoma was the most common type of malignancy(82.1% ). The remainings were mucinous adenocarcinoma, undifferentiated carcinoma, duct cell carcinoma, acinar cell carcinoma, cystadenocarcinoma, papillary adenocarcinoma and epidermoid carcinoma. Among 163 pa- tients who could be evaluated the clinical stages, only 6 cases(3.7% ) belong to stage I and the number of patients belong to stage II, stage III and stage IV were 14(8.6% ), 46(28.2% ), 97(59.5% ) cases respectively. And the two common sites of distant metastasis were liver(42.9 %) and peritoneum(22.7%). The median survival of 100 patients who could be evaluated the survival was 4.2 months. The survival rates were 35.9% at 6 months, 14.7% at 12 months and 4.0% at 24 months. There was no significant difference in survival rates according to the loca- tion of the tumor. The survival rate of the patients with stage I was significantly higher than that of the rest of patients with other stages(p<0.05). According to the treatment modalities, the median survival was 3.1 months in the group of no treatment, 4.3 months in surgical drainage group, 9.7 months in chemotherapy and/or radiotherapy group and 19.4 months in curative resection group. The survival rate of curative resection group was significantly higher than that of other treatment group(p<0.05). The survival rate of surgical drainage group was significantly higher than that of no treatment group(p<0.05).