Prognostic factors after distal pancreatectomy with extended lymphadenectomy for invasive pancreatic adenocarcinoma of the body and tail.
BACKGROUND
Invasive pancreatic carcinoma originating from the body and tail usually is diagnosed at a late stage, and resection is considered a palliative procedure because of the poor prognosis. Factors predicting survival were not evaluated fully in patients with invasive pancreatic carcinoma of the body and tail who had undergone distal pancreatectomy with extended lymphadenectomy.


METHODS
Between 1990 and 2004, 88 patients with invasive pancreatic carcinoma of the body and tail underwent distal pancreatectomy with extended lymphadenectomy. Univariate and multivariate models were used to analyze the effects of clinicopathologic factors on long-term survival.


RESULTS
No operative deaths occurred. The median survival time was 22 months, and the 1-, 3-, and 5-year survival rates were 76%, 40%, and 19%, respectively. Lymph node involvement status and the degree of histologic vein invasion were independent predictors of long-term survival.


CONCLUSIONS
Distal pancreatectomy with extended lymphadenectomy for the treatment of invasive pancreatic carcinoma of the body and tail contributed to long-term survival in selected patients without mortality. Effective postoperative treatment should be evaluated in patients with positive lymph nodes and/or the presence of histologic vein invasion even after a curative resection because long-term survival cannot be expected.
Shimada
Kazuaki
K
Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. kshimada@ncc.go.jp
Sakamoto
Yoshihiro
Y
Sano
Tsuyoshi
T
Kosuge
Tomoo
T
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome