The role of extended radical operation for pancreatic cancer.
OBJECTIVE
To clarify the indication of extended operation for pancreatic carcinoma, a clinical study was carried out.


METHODS
From July 1981 to 1999, 196 of 307 (63.8%) patients with pancreatic carcinoma underwent resection of the tumor. Portal vein resection was performed in 145 of these 196 (74.0%) resected cases. The postoperative survival rate was studied according to the operative and histopathological findings.


RESULTS
In spite of the aggressive surgery, there was no patient who survived over 3 years after operation in the group carcinoma-positive on the surgical margins. Patients who survived over 3 years postoperatively were observed in the group of carcinoma-free surgical margins.


CONCLUSIONS
The most important indication of extended operation combined with portal vein resection for pancreatic cancer is to obtain surgical cancer-free margins. There is no indication of extended operation for cases in which surgical margins will become cancer-positive, if such an operation is employed.
Nakao
A
A
Department of Surgery II, Nagoya University School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya 466-8550, Japan. nakaoaki@tsuru.med.nagoya-u.ac.jp
Kaneko
T
T
Takeda
S
S
Inoue
S
S
Harada
A
A
Nomoto
S
S
Ekmel
T
T
Yamashita
K
K
Hatsuno
T
T
D003251:Constriction, Pathologic; D006801:Humans; D009361:Neoplasm Invasiveness; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011169:Portal Vein / Q000473:pathology / Q000601:surgery; D016019:Survival Analysis