title: Adenocarcinoma of the pancreas: a multimodality approach--a single surgeon's experience (1979-1988).
abstract: A retrospective review of a single surgeon's experience with adenocarcinoma of the pancreas was performed. One hundred-one patients were treated over a 10-year period from 1979 to 1988. Seven patients underwent potentially curative resections and 28 patients presented with metastatic (stage IV) disease. Sixty-four patients had locally advanced and unresectable primary lesions. A total of 51 patients received I-125 seed implantation. There was no statistically significant difference in morbidity (33% vs. 30%) or mortality (6% vs. 8%) between patients receiving I-125 implantation and those undergoing palliative surgical procedures without implantation. Operative mortality was highest in patients presenting with stage IV lesions (11%). In those patients with locally advanced and unresectable carcinomas, there was a nonsignificant increase in survival (12.8 mo vs. 10.7 mo) in those receiving intraoperative I-125 implants when compared to those who did not when both groups received postoperative adjuvant chemotherapy and external beam radiotherapy. Based on these encouraging results, it is concluded that I-125 implantation can be performed safely and shows a trend toward improving long-term survivorship in patients with locally advanced pancreatic carcinoma when used in conjunction with chemotherapy and external beam radiation.
authors.affiliation: Department of Surgery, Thomas Jefferson University Philadelphia, Pennsylvania.
authors.forename: A L
authors.initials: AL
authors.lastname: Schuricht
authors.forename: D J
authors.initials: DJ
authors.lastname: Barbot
authors.forename: M
authors.initials: M
authors.lastname: Mohiuddin
authors.forename: F E
authors.initials: FE
authors.lastname: Rosato
mesh_terms: D000206:Actuarial Analysis; D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate