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Long-term Results after Radical Resections for Pancreatic Ductal Adenocarcinoma – 10 Years Experience


Authors: T. Krejčí;  J. Leffler;  P. Polouček
Authors‘ workplace: Chirurgická klinika UK 2. LF a FN Motol, přednosta: prof. MUDr. J. Hoch, CSc.
Published in: Rozhl. Chir., 2007, roč. 86, č. 4, s. 174-179.
Category: Monothematic special - Original

Overview

Introduction:
Pancreatic ductal adenocarcinoma is the most often and the most malignant type of pancreatic tumor. Effective systemic anticancer treatment is still missing and only radical resection can potentially lead to the life prolongation.

Target:
Long-term therapeutic outcomes evaluation in patients after radical resections due to the pancreatic ductal adenocarcinoma during the 10 years period.

Material and methods:
Population included 42 patients after resection of pancreas due to ductal adenocarcinoma realized during the period from 1995 to 2005. Therapeutic outcomes including long-term survival in different stages of the disease were compared with data collected from patients with another histological type of periampullar tumor by statistical analysis.

Results:
48 radical resections of pancreas due to ductal adenocarcinoma were realized during the 10 years period. Six patients were excluded from the follow up. Median of survival with the minimum 6 months of follow up has reached 14 months and the maximal survival time was 35 months. None of the patients has survived 5 years. Five patients were alive after the end of follow up period. There were no statistical difference in survival when particular disease stages were compared (p = 0.3226). Survival of female patients in this population was statistically lower in comparison to male patients (p = 0.0222). Significantly lower survival of patients with ductal adenocarcinoma in comparison to the patients with other types of carcinoma in periampullar localization was demonstrated (p = 0.0234).

Conclusion:
Achieved results proved that pancreatic carcinoma is solid tumor with the worst long-term prognosis. Long-term survival in this population did not exceed 35 months and was independent on per-operative staging. Long-term prognosis of ductale adenocarcinoma is significantly worse in comparison to other types of carcinoma in periampullar localization.

Key words:
pancreatic ductal adenocarcinoma – long-term survival – radical resection


Sources

1. Nitecky, S. S., Sarr, M. G., Thomas, V. C. Long-term survival after resection for ductal adenocarcinoma of the pancreas. Is it really improving? Ann. Surg., 1995; 221: 1, 59–66.

2. Conlon, K. C., Klimstra, D. S., Brennan, M. F. Long-term survival after curative resection for pancreatic ductal adenocacrinoma. Clinicopathologic analysis of 5-year survivors. Ann. Surg., 1996; 223: 3, 273–279.

3. Alexakis, N., Halloran, C., Raraty, P., et al. Current standards of surgery for pancreatic cancer. B. J. Surg., 2004; 91: 1410–1427.

4. Leffler, J., Polouček, P., Krejčí, T. Karcinom hlavy pankreatu a periampulární karcinomy. Výsledky resekční léčby za 10 let. Rozhl. Chir., 2005; 84: 12, 610–616.

5. Boettger, T. C., Junginger, T. Factors influencing morbidity and mortality after pancreaticoduodenectomy: Critical analysis of 221 resections. World J. Surg., 1999; 23: 164–172.

6. Wingo, P. A., Tong, T., Bolden, S. Cancer statistics 1995. Cancer J. Clin., 1995; 45: 8–30.

7. Gudjonsson, B. Carcinoma of the pancreas: critical analysis of costs, results of resections, and the need for standardized reporting. J. Am. Coll. Surg., 1995; 181: 483–503.

8. Pedrazolli, S., DiCarlo, V., Dionigi, R., et al. Traditional versus extended lymphadenectomy associated with pancreatoduodenectomy in the surgical treatment of adenocarcinoma of the head of pancreas. A multicentric, prospective, randomised study. Ann. Surg., 1999; 230: 508.

9. Yeo, C. J., Cameron, J. L., Lillemoe, K. D., et al. Pancreaticoduodenectomy with or without distal gastrectomy and extended retroperitoneal lymphadenectomy for periampullary adenocarcinoma. Randomized controlled trial evaluating survival, morbidity and mortality. Ann. Surg., 2002; 236: 355.

10. Ryska, M., Bělina, F., Strnad, R., a kol. Resekční výkon – metoda volby terapie karcinomu pankreatu. Předběžná analýza vlastní sestavy. Bulletin HPB chir., 2004; 12: 3, 90.

11. Zavoral, M., a kol. Karcinom pankreatu. Galén, 2005.

12. Novotvary 2003. ÚZIS – Ročenka 2003.

13. Richter, A., Niedergethmann, M., Sturm, J. W., et al. Long-term results of partial pancreaticoduodenectomy for ductal adenocarcinoma of the pancreatic head: 25-year experience. World J. Surg., 2003; 27: 324–329.

14. Carpelan-Holmstroem, M., Nordling, S., Pukkala, E., et al. Does anyone survive pancreatic ductal adenocarcinoma? A nationwide study re-evaluating the data of the Finnish Cancer Registry. Gut, 2005; 54: 385–387.

15. Lim, J. E., Chien, M. W., Earle, C. C. Prognostic factors following curative resection for pancreatic adenocarcinoma. A population-based, linked database analysis of 396 patients. Ann. Surg., 2003; 237: 1, 74–85.

16. Moon, H. J., An, J. Y., Choi, S. H., et al. Predicting survival after surgical resection for pancreatic ductal adenocarcinoma. Pancreas, 2006; 32: 37–43.

17. Winter, J. M., Cameron, J. L., Campbell, K. A., et al. 1423 pancreaticoduodenectomies for pancreatic cancer: A single – institution experience. J. Gastroint. Surg., 2006; 10: 9, 1199–1211.

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