当科におけるStage IVb膵癌の治療成績

Pancreatic cancer is often detected in a far advanced stage and the prognosis is still extremely poor. A clinicopathological study was made on 49 patients with Stage IVb pancreatic cancer treated at our department from March 1994 to February 2002. In this study, patient factors (age and gender), tumor factors (hepatic metastasis, peritoneal dissemination, and distant metastasis), and treatment factors (systemic chemotherapy, intra- and postoperative radiotherapy, some treatments to hepatic metastasis, and surgical resection) were examined, and the survival was evaluated statistically. Overall mean survival was 150 days and the 1-year survival rate was 0%. With multivariate analysis, prognostic factors were hepatic metastasis, peritoneal dissemination and some treatments to hepatic metastasis. In advanced pancreatic cancer with hepatic metastasis, the prognostic factor was just some treatments to hepatic metastasis. Systemic chemotherapy with somatostatin analog was ineffective. At present we use either gemcitabine or 5FU in systemic chemotherapy for Stage IVb pancreatic cancers without hepatic metastasis, and conduct hepatic arterial infusion therapy for those with hepatic metastasis.