title: Prognosis and feasibility of en-bloc vascular resection in stage II pancreatic adenocarcinoma.
abstract: OBJECTIVE
  To establish the prognosis and feasibility of en-bloc vascular resection of stage II pancreatic adenocarcinoma of the head and uncinate process.
  
  
  METHODS
  We retrospectively analyzed 87 patients with stage II pancreatic adenocarcinoma, who were subjected to pancreaticoduodenectomy (PD) and pylorus-preserving PD (PPPD) between 1996 and 2006 in Chang Gung Memorial Hospital, Taiwan. Twelve and 75 patients underwent PD/PPPD with and without resection of portal vein/superior mesenteric vein (PV/SMV), respectively.
  
  
  RESULTS
  The overall 1- and 3-year survival rates of patients undergoing PD/PPPD with and without vascular resection were 50.0% and 16.7%, and 44.4% and 12.2%, respectively. Morbidity and mortality rates in the PV/SMV resection vs non-resection group were 50.0% and 0.0%, and 40.0% and 2.7%, respectively. In multivariate analysis, serum bilirubin, histological differentiation and adjuvant chemotherapy were independent prognostic factors that influenced survival.
  
  
  CONCLUSIONS
  In stage II adenocarcinoma of the pancreatic head and uncinate process, serum bilirubin, histological differentiation and adjuvant chemotherapy were independent prognostic factors, and en-bloc vascular resection is a feasible option in carefully selected patients.
authors.affiliation: Department of General Surgery, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Kwei-Shan Shiang, Taoyuan 333, Taiwan, China.
authors.forename: K Dilip
authors.initials: KD
authors.lastname: Chakravarty
authors.forename: Jun-Te
authors.initials: JT
authors.lastname: Hsu
authors.forename: Keng-Hao
authors.initials: KH
authors.lastname: Liu
authors.forename: Chun-Nan
authors.initials: CN
authors.lastname: Yeh
authors.forename: Ta-Sen
authors.initials: TS
authors.lastname: Yeh
authors.forename: Tsann-Long
authors.initials: TL
authors.lastname: Hwang
authors.forename: Yi-Yin
authors.initials: YY
authors.lastname: Jan
authors.forename: Miin-Fu
authors.initials: MF
authors.lastname: Chen
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000601:surgery*; D008875:Middle Aged; D009367:Neoplasm Staging; D010179:Pancreas / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D011169:Portal Vein / Q000601:surgery*; D011379:Prognosis; D015996:Survival Rate