Pancreaticoduodenectomy with vascular resection for local advanced pancreatic head cancer: a single center retrospective study.
BACKGROUND
Pancreaticoduodenectomy with vascular resection remains a controversial approach for patients with local advanced pancreatic head cancer for the lack of evidences of survival and quality of life benefits. The aim of this study was to evaluate whether patients of pancreatic head cancer benefit on quality of life, survival, and treatment cost from pancreaticoduodenectomy with vascular resection compared with palliative therapy.


METHODS
Two hundred fourteen patients of pancreatic head cancer whose pancreatic head could not be dissected free from adjacent vascular were involved in this study. Eighty of these patients underwent pancreaticoduodenectomy with vascular resection, whereas other patients underwent palliative therapy.


RESULTS
Pancreaticoduodenectomy with artery resection offered worse outcomes on almost all aspects of quality of life and survival compared with palliative therapy. Pancreaticoduodenectomy with vein resection offered better 5-year survival compared with palliative therapy, whereas palliative therapy offered better quality of life after surgery.


CONCLUSIONS
Pancreaticoduodenectomy with artery resection is nonsensical on treatment of pancreatic head cancer with artery adhesion/invasion. As for patients with vein adhesion/invasion, pancreaticoduodenectomy with vein resection should be performed cautiously. When actual vein invasion is very possible to have taken place, the choice of treatment strategy should be considered carefully by the pancreatic surgeons.
Wang
Chunyou
C
Pancreatic Center, Department of General Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Ave 1277#, Wuhan City, Hubei Province, 430022, China. chunyouwang52@126.com
Wu
Heshui
H
Xiong
Jiongxin
J
Zhou
Feng
F
Tao
Jing
J
Liu
Tao
T
Zhao
Gang
G
Gou
Shanmiao
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005260:Female; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010166:Palliative Care / Q000191:economics; D010179:Pancreas / Q000098:blood supply*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000191:economics; D011788:Quality of Life; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome