title: Carcinoma of the head of the pancreas.
abstract: 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.
authors: Department of Surgery, Toyohashi Municipal Hospital, 50 Hachiken-nishi, Aotake-cho, Toyohashi, Aichi 441-8085, Japan.
authors: Shigemi
authors: S
authors: Onoue
authors: Takehito
authors: T
authors: Katoh
authors: Haruhiko
authors: H
authors: Chigira
authors: Yoshihisa
authors: Y
authors: Shibata
authors: Koji
authors: K
authors: Matsuo
authors: Masaomi
authors: M
authors: Suzuki
mesh_terms: 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