Carcinoma of the head of the pancreas.
OBJECTIVE
Extended radical surgery might provide a survival advantage for patients with carcinoma of the head of the pancreas.


METHODS
Between January 1980 and December 1999, 144 patients with carcinoma of the head of the pancreas were treated in a community hospital setting, of whom 69 patients who underwent radical surgery were retrospectively reviewed. Surgical procedures included standard pancreaticoduodenectomy (27 patients), pylorus-preserving pancreaticoduodenectomy (27 patients), and total pancreatectomy (15 patients). Portal vein resection was performed for 15 patients. Retroperitoneal lymphadenectomy was performed for 35 patients. No patients received adjuvant chemotherapy or radiotherapy.


RESULTS
The surgical resection rate was 47.9% with a surgical mortality rate of 4.3% during this period. The overall 5-year survival rate after radical surgery was 16.1% with a median survival of 12 months. Seven patients survived five years, making 16.3% of the patients available for a more than 5-year follow-up. Long-term survivors had less than two positive lymph nodes in the posterior pancreatic head. Fourteen of 15 patients undergoing portal vein resection died within 21 months. One patient having no portal vein invasion microscopically survived 27 months without recurrence.


CONCLUSIONS
Extended radical surgery did not prolong survival for patients with carcinoma of the head of the pancreas.
Onoue
Shigemi
S
Department of Surgery, Toyohashi Municipal Hospital, 50 Hachiken-nishi, Aotake-cho, Toyohashi, Aichi 441-8085, Japan.
Katoh
Takehito
T
Chigira
Haruhiko
H
Shibata
Yoshihisa
Y
Matsuo
Koji
K
Suzuki
Masaomi
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011169:Portal Vein / Q000601:surgery; D012189:Retrospective Studies; D016019:Survival Analysis