EVALUATION OF THE EFFECT OF PANCREATIC RESECTION IN ADVANCED PANCREATIC-CANCER WITH SPECIAL REFERENCE USING HOSPITAL-FREE SURVIVAL AS A MEASURE OF QUALITY-OF-LIFE

Comparisons of surgical procedures and the identification of prognosti c factors in pancreatic cancer were carried out on 158 patients who un derwent surgery in Aichi Cancer Center from 1975 to 1991 for advanced pancreatic ductal adenocarcinoma. Survival and 'hospital-free survival (HFS),(1) which we consider the best general means of measuring quali ty of life (QOL) in such severe and often fatal disease, were identifi ed as primary end points, and the effect of pancreatectomy, compared w ith palliative surgery (by-pass operation, etc.) for TNM Stages III an d IV pancreatic Cancer was evaluated. Both survival and HFS were signi ficantly longer in the group of patients who underwent panreatectomies (R group, n 25) compared to the group without pancreatic resections ( NR group, n 35) in Stage III cases. In Stage IV cases, however, no sig nificant difference was observed between the R (n 12) and NR (n 86) gr oups. From these results, we conclude that an extensive pancreatic res ection against Stage III pancreatic cancer may improve prognosis. For Stage IV pancreatic cancers, however, agressive surgery might not alwa ys be beneficial either for survival or for QOL.