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Evaluation of Surgical Resection for Pancreatic Carcinoma at a Japanese Single Cancer Institute

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Title: Evaluation of Surgical Resection for Pancreatic Carcinoma at a Japanese Single Cancer Institute
Authors: Nanashima, Atsushi / Tobinaga, Syuuichi / Abo, Takafumi / Hatano, Kazuhiko / Takeshita, Hiroaki / Nonaka, Takashi / Hidaka, Shigekazu / Tanaka, Kenji / Kunizaki, Masaki / Sawai, Terumitsu / Yasutake, Toru / Nagayasu, Takeshi
Issue Date: May-2012
Publisher: H.G.E. Update Medical Publishing Ltd.
Citation: Hepato-gastroenterology, 59(115), pp911-915; 2012
Abstract: Background/Aims: Surgical resection is a radical treatment option for pancreatic carcinoma (PC); however, it is still difficult to cure and patient prognosis is poor at this stage. Methodology: We examined the demographics, surgical records and outcome in 64 patients with hilar PC undergoing surgical resection. Results: Pancreatoduodenectomy (PD) was carried out in 48 patients, distal pancreatectomy (DP) in 14 and total pancreatectomy in two. Postoperative complications were observed in 18 patients (28%) but no hospital deaths. All stage I patients showed carcinoma in situ of intraductal papillary mucinous carcinoma (IPMC). Postoperative adjuvant chemotherapy was performed in 15 patients (23%) using gemcitabine or S-1. Cancer recurrence was observed in 36 patients (56%) and 31 died of carcinoma. The 5-year cancer-free and overall survival rate was 12% and 14%, respectively. CA19-9 level, morphological type, T category, lymph node metastasis, extrapancreatic nerve plexus invasion, retropancreatic tissue invasion, distal bile duct invasion, duodenal invasion and arterial system invasion were significant poor prognostic factors; however, portal vein system invasion was not significantly associated with prognosis. Cancer infiltration at bile duct cut-end and dissected peripancreatic tissue margin and presence of residual tumor showed a poor prognosis. Surgical prognosis in only non-invasive IPMC was satisfactory. Conclusions: Radically extended surgical resection is necessary and newly effective adjuvant chemotherapy is a promising modality to improve patient survival in PC patients.
Keywords: Pancreatoduodenectomy / Distal pancreatectomy / Pancreatic carcinoma; Curability
URI: http://hdl.handle.net/10069/28626
ISSN: 01726390
DOI: 10.5754/hge10038
PubMed ID: 22469741
Rights: © H.G.E. Update Medical Publishing S.A.
Type: Journal Article
Text Version: author
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/28626

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