title: Prognostic factors after resection of pancreatic cancer.
abstract: OBJECTIVE
  The purpose of this study was to identify important prognostic factors related to the status of a pancreatic tumor, its treatment, and the patient's general condition.
  
  
  METHODS
  Between April 1992 and December 2006, 140 patients underwent a pancreatic resection for invasive ductal carcinoma. Prognostic factors were defined by univariate and multivariate analyses.
  
  
  RESULTS
  The study included 103 tumors in the head of the pancreas and 37 tumors in the body or tail. The median survival time and the actuarial 5-year survival rate for all patients were 14.5 months and 12.3%, respectively. Using the significant prognostic factors identified by univariate analysis, multivariate analysis revealed that a preoperative serum CA19-9 concentration>100 U/ml (HR=1.84, p=0.0074), a tumor size>3 cm (HR=1.74, p=0.0235), venous involvement (HR=2.39, p=0.0006), a transfusion requirement of >or=1000 ml (HR=2.23, p=0.0006), and a serum albumin concentration on 1 postoperative month (1POM)<3 g/dl (HR=2.40, p=0.0009) were significant adverse prognostic factors. The presence of hypoalbuminemia on 1POM significantly correlated with a longer surgical procedure (p=0.0041), extended nerve plexus resection around the superior mesenteric artery (p=0.0456), and a longer postoperative hospital stay (p=0.0063).
  
  
  CONCLUSIONS
  To improve long-term survival, preserving the patient's general condition by performing a curative resection with a short operation time and minimal blood loss should be the most important principle in the surgical treatment of pancreatic cancer.
authors.affiliation: Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. michio-u@ya2.so-net.ne.jp
authors.forename: Michio
authors.initials: M
authors.lastname: Ueda
authors.forename: Itaru
authors.initials: I
authors.lastname: Endo
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nakashima
authors.forename: Yuta
authors.initials: Y
authors.lastname: Minami
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takeda
authors.forename: Kenichi
authors.initials: K
authors.lastname: Matsuo
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Nagano
authors.forename: Kuniya
authors.initials: K
authors.lastname: Tanaka
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ichikawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Togo
authors.forename: Chikara
authors.initials: C
authors.lastname: Kunisaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimada
mesh_terms: D000704:Analysis of Variance; D018395:CA-19-9 Antigen / Q000097:blood; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D034141:Hypoalbuminemia / Q000401:mortality; D007564:Japan / Q000453:epidemiology; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D011184:Postoperative Period; D011379:Prognosis; D018570:Risk Assessment; D015996:Survival Rate
chemical_list: D018395:CA-19-9 Antigen