title: Predicting survival after surgical resection for pancreatic ductal adenocarcinoma.
abstract: OBJECTIVE
  We reviewed the pancreatectomies that were done for pancreatic ductal adenocarcinoma to evaluate patient survival and prognostic predictors.
  
  
  METHODS
  A review was performed on 94 patients who underwent surgical resection for pancreatic ductal adenocarcinomas from 1995 to 2002. The perioperative factors were compared between the proximal and distal lesions by the chi2 test and t test. Possible predictors for survival were examined for by univariate and multivariate analysis.
  
  
  RESULTS
  The 5-year survival was 16%. The proximal lesions had a smaller tumor size (3.0 +/- 0.11 vs. 3.9 +/- 0.33 cm, respectively; P = 0.03), a higher incidence of nodal involvement (60.6% vs. 34.8%, respectively; P = 0.031), and poorer histologic differentiation (25.4% vs. 13.0%, respectively; P = 0.01) compared with the distal lesions, and both types of lesions had similar rates of intraoperative transfusion, complete resection, and survival. The factors shown to have favorable independent prognostic significance were negative resection margins (hazard ratio [HR] = 0.23; 95% confidence interval [CI] = 0.12-0.42; P < 0.001), a tumor diameter less than 3 cm (HR = 0.46; 95% CI = 0.27-0.78; P = 0.004), well/moderate tumor differentiation (HR = 0.37; 95% CI = 0.19-0.72; P = 0.004), and adjuvant therapy (HR = 0.61; 95% CI = 0.37-0.99; P = 0.49).
  
  
  CONCLUSIONS
  For the long-term survival of patients with pancreatic ductal adenocarcinoma, complete excision is the most important therapeutic option, and adjuvant therapy is a significant contributing factor.
authors.affiliation: Department of Surgery, Myoungji Hospital, Kwandong University College of Medicine, Goyang, Korea.
authors.forename: Hyoun Jong
authors.initials: HJ
authors.lastname: Moon
authors.forename: Ji Yeong
authors.initials: JY
authors.lastname: An
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Heo
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Jae Won
authors.initials: JW
authors.lastname: Joh
authors.forename: Yong Il
authors.initials: YI
authors.lastname: Kim
mesh_terms: D000206:Actuarial Analysis; D000230:Adenocarcinoma / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors