title: Pancreaticoduodenectomy for nonperiampullary primary tumors.
abstract: BACKGROUND
  This review was performed to evaluate the outcome of patients undergoing pancreaticoduodenectomy (PD) for isolated metastatic or locally advanced nonperiampullary tumors at a single institution over a 13-year period.
  
  
  METHODS
  Between 1983 and 1996, patients undergoing PD for metastatic or locally advanced nonperiampullary malignancies were identified. Medical records were reviewed and outcome factors and survival data analyzed.
  
  
  RESULTS
  Eighteen patients were identified. The primary tumor histopathology included colon (n = 7), gastric (n = 4), renal cell (n = 3), lung (n = 2), bladder (n = 1), and melanoma (n = 1). The median length of hospital stay was 15 days (6 to 48) with one perioperative death (5.5%). The median tumor size was 5.5 cm (0.8 to 11.5), and 7 patients had positive peripancreatic lymph nodes. The median survival was 40 months, with a 5-year survival of 35%.
  
  
  CONCLUSIONS
  Pancreaticoduodenectomy for nonperiampullary malignancy is infrequently indicated. However, in the absence of widely metastatic disease, PD should be considered for locally advanced tumors or isolated metastatic malignancy.
authors.affiliation: Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
authors.forename: L E
authors.initials: LE
authors.lastname: Harrison
authors.forename: N
authors.initials: N
authors.lastname: Merchant
authors.forename: A M
authors.initials: AM
authors.lastname: Cohen
authors.forename: M F
authors.initials: MF
authors.lastname: Brennan
mesh_terms: D002292:Carcinoma, Renal Cell / Q000556:secondary / Q000601:surgery; D003110:Colonic Neoplasms / Q000473:pathology; D004379:Duodenal Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology; D007902:Length of Stay; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D013274:Stomach Neoplasms / Q000473:pathology; D015996:Survival Rate; D016896:Treatment Outcome