Analysis of long-term survivors after surgical resection for pancreatic cancer.
OBJECTIVE
The purpose of this study was to determine the outcome of surgical resection for pancreatic cancer and to characterize the clinicopathologic features of actual long-term survivors.


METHODS
Of the 789 pancreatic cancer patients, we retrospectively analyzed 242 patients who underwent an operation between 1985 and 1999. Surgical resection with curative intent was performed in 123 patients. We analyzed the overall results of surgical treatment, compared the clinicopathologic features between long-term and short-term survivors, and reevaluated the histological slides of the long-term survivors.


RESULTS
Median survival and cumulative 5-year survival rate after surgical resection were 14.8 months and 12.1%. Tumor size, American Joint Committee on Cancer stage, resection margin involvement, and lymph node metastases were the significant prognostic factors. Eleven patients survived for more than 5 years. Some patients with poor prognostic factors such as lymph node metastasis and big tumor size survived for more than 5 years. Histological reevaluation in the long-term survivors revealed 4 cases of variant adenocarcinoma (anaplastic carcinoma, mucinous noncystic adenocarcinoma [n = 2], and undifferentiated carcinoma).


CONCLUSIONS
Active surgical resection should be attempted even in patients with poor prognostic factors. As there were various types of pathology among the long-term survivors, typical ductal adenocarcinoma of the pancreas might have a poorer survival rate.
Han
Sung-Sik
SS
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Jang
Jin-Young
JY
Kim
Sun-Whe
SW
Kim
Woo-Ho
WH
Lee
Kuhn Uk
KU
Park
Yong-Hyun
YH
D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D017741:Survivors