Debate: extended resection for pancreatic cancer; the affirmative case.
OBJECTIVE
A clinical study was carried out to clarify the indications for extended resection of pancreatic cancer.


METHODS
From July 1981 to April 2000, 200 of 314 (63.7%) patients with pancreatic cancer underwent extended tumor resection. Portal vein resection was performed in 146 of the 200 (73%) resected cases. The postoperative survival rate was studied based on the operative and histopathological findings.


RESULTS
Operative death (within 30 days postoperatively) occurred in 11 of the 200 (5.5%) resected patients. Most of the patients who survived for 2 or 3 years were in the group with carcinoma-free surgical margins.


CONCLUSIONS
The most important indication for an extended operation combined with portal vein resection for pancreatic cancer is the likelihood of obtaining surgical cancer-free margins. There is no indication for an extended resection inpatients in whom the surgical margins will become cancer-positive if such a resection is employed.
Nakao
Akimasa
A
Second Department of Surgery, Nagoya Unversity Hospital, Nagoya, Japan.
D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D009361:Neoplasm Invasiveness; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011169:Portal Vein / Q000601:surgery*; D011379:Prognosis