Nodal involvement is strongest predictor of poor survival in patients with invasive adenocarcinoma of the head of the pancreas.
OBJECTIVE
Pancreatic cancer is a devastating disease with an extremely poor prognosis. The outcome of pancreatic head cancer after surgical resection is still difficult to predict.


METHODS
Between September 1992 and December 2003, 100 consecutive patients with invasive adenocarcinoma of the head of the pancreas who underwent surgical resection were retrospectively analyzed to clarify the influence of clinicopathological factors.


RESULTS
The overall 1-, 3-, and 5-year survival rates for the 100 patients with pancreatic head cancer were 55%, 16%, and 6%, respectively. Among the 16 clinicopathologic factors, 9 were significantly associated with outcome in univariate analysis: tumor type (invasive ductal cancer), poor histological differentiation, extrapancreatic plexus invasion, bile duct invasion, duodenal invasion, intrapancreatic nerve invasion, lymphatic invasion, venous invasion, and nodal involvement. Multivariate analysis confirmed that nodal involvement (p = 0.005) and extrapancreatic plexus invasion (p = 0.03) were significant independent factors for overall survival.


CONCLUSIONS
Nodal involvement was the strongest predictor of poor survival after pancreatic resection for invasive adenocarcinoma of the head of the pancreas.
Nakagohri
Toshio
T
Department of Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa 277-8577, Japan. tnakagor@east.ncc.go.jp
Kinoshita
Taira
T
Konishi
Masaru
M
Takahashi
Shinichiro
S
Gotohda
Naoto
N
D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002454:Cell Differentiation; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis