术后体重减轻对胰腺癌切除后生存的影响

　　背景：本研究旨在评估胰腺癌术后体重减轻对其长期生存质量的影响。

　　方法：共纳入了93例在年4月～年12月期间因原发性胰腺癌进行胰腺切除的患者。对患者特点、术前体重指数以及术后体重变化进行了回顾性评价，并分析了其与长期生存质量的关联。

　　结果：生存率与术前体质指数没有明显关联。术后2个月体重降低了8.4%，术后4个月降低了9.0%。严重的术后体重减轻，无论是术后2个月（P=0.）还是4个月（P=0.）与预后差明显相关，尤其在处于IA～IIA期胰腺癌的患者中（n=43）（2个月，P=0.；4个月，P＜0.）。此外，虽然在处于IIB～III期胰腺癌患者（n=50）中，严重体重减轻与其生存期缩短趋向于相关，但差异无显著性。多因素分析结果表明：术后体重减轻是评估预后的独立因素。

　　结论：本研究结果表明出现严重体重减轻的胰腺癌患者预后较差。

JPENJParenterEnteralNutr.;39(5):-.

ImpactofPostoperativeWeightLossonSurvivalAfterResectionforPancreaticCancer.

HashimotoD,ChikamotoA,OhmurayaM,AbeS,NakagawaS,BeppuT,TakamoriH,HirotaM,BabaH.

KumamotoUniversityGraduateSchoolofMedicalSciences,Japan.

SaiseikaiKumamotoHospital,Japan.

KumamotoRegionalMedicalCenter,Japan.

BACKGROUND:Theaimofthisstudywastoassesstheeffectsofpostoperativebodyweightlossonlong-termsurvivalafterresectionforpancreaticcancer.

METHODS:Atotalof93patientswithprimarypancreaticcancerunderwentpancreaticresectionbetweenAprilandDecember.Patientcharacteristics,preoperativebodymassindex,andchangesinpostoperativebodyweightwereevaluatedretrospectivelyandcorrelatedwithlong-termsurvival.

RESULTS:Therewasnosignificantassociationbetweensurvivalandpreoperativebodymassindex.Bodyweightfellby8.4%at2monthsaftersurgeryandby9.0%at4monthsaftersurgery.Severepostoperativebodyweightlosses,bothat2months(P=.)and4months(P=.)aftersurgery,weresignificantlyassociatedwithpoorprognosis,especiallyamongpatientswithstageIA-IIApancreaticcancer(n=43)(P=.at2monthsandP.at4months).Additionally,severebodyweightlosstendedtobeassociatedwithshortersurvivalamongpatientswithstageIIB-IIIpancreaticcancer(n=50),althoughthedifferencewasnotsignificant.Multivariateanalysisrevealedthatpostoperativebodyweightlosswasanindependentprognosticfactor.

CONCLUSIONS:Theresultsofthisstudydemonstratedthatpancreaticcancerpatientswithseverepostoperativebodyweightlosshavepoorerpostoperativeout







































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