Objective To study the survival of patients with pancreatic head carcinoma undergoing surgery,and to evaluate the clinicopathological factors associated with prognosis.Methods The data of 4 814 patients who underwent surgery for pancreatic head carcinoma from 2004 to 2009 were extracted from the US SEER database.The life table was used to calculate the survival rate at 5-years.The Kaplan-meier method was used to construct the survival curves of the patients.The univariate and Cox multivariate regression analysis were applied to evaluate the prognostic factors.and the univariate analysis was evaluated by the log-rank x2 test.Results The overall 5-year survival of 4 818 pancreatic head carcinoma patients was 16.3％.The median survival was 18.9 months,and the 5-year survival rates of the stage Ⅰ A,Ⅰ B,Ⅱ A,Ⅱ B,Ⅲ and Ⅳ patients were 38.8％,35.3％,21.8％,12.2％,9.1％,and 7.3％,respectively.The difference was statistically significant (x2 =287.702;P ＜ 0.05).The factors including sex,age,years of diagnosis,pathological grading,tumor size,extent of invasion,lymph node metastasis,distant metastasis,and pathological pattern (all P ＜ 0.05) influenced the survival rate on univariate analysis.There was no clear correlation between race,number of lymph node examined and prognosis.The factors including sex,age,years of diagnosis,pathological grading,tumor size (AJCC 8th),range,extent of invasion,lymph node metastasis,distant metastasis,and pathological pattern (all P ＜ 0.05) were independent prognostic factors on multivariate analysis.Conclusions With the increase of TNM staging,the overall survival of patients with pancreatic head carcinoma undergoing surgery gradually decreased.Factors including sex,age,years of diagnosis,pathological grading,tumor size,extent of invasion,lymph node metastasis,distant metastasis,and pathological pattern were independent prognostic factors of overall survival.%目的 探讨胰头癌术后患者的预后,分析临床病理特征对其预后的影响.方法 提取美国SEER数据库2004至2009年共4 814例行手术治疗且病理学明确诊断为胰头癌患者的临床病理数据.寿命表法计算5年生存率;Kaplan-Meier法绘制患者生存曲线;采用单因素log-rank x2检验和多因素Cox回归分析胰头癌患者预后影响因素.结果 4 814例胰头癌患者的5年生存率为16.3％,中位生存时间为18.9个月.ⅠA、ⅠB、ⅡA、ⅡB、Ⅲ、Ⅳ期患者5年生存率分别为38.8％、35.3％、21.8％、12.2％、9.1％、7.3％,差异有统计学意义(X2=287.702,P＜0.05).单因素分析显示,性别、年龄、诊断年份、分化程度、肿瘤大小、侵袭范围、阳性淋巴结数、有无远处转移、病理类型与预后相关(均P ＜0.05),人种、淋巴结检出数与预后无明显相关性.多因素Cox回归分析显示,性别、年龄、诊断年份、分化程度、肿瘤大小、侵袭范围、阳性淋巴结数、有无远处转移、病理类型是影响胰头癌患者生存预后的独立危险因素(均P＜0.05).结论 随着胰头癌TNM分期的增加,接受根治手术患者的总体生存率逐渐降低.性别、年龄、诊断年份、分化程度、侵袭范围、阳性淋巴结数、是否远处转移、病理类型等参数是评估胰头癌术后患者预后的独立指标.
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