RESULTS OF RESECTION FOR CANCER OF THE EXOCRINE PANCREAS - A STUDY FROM THE FRENCH-ASSOCIATION-OF-SURGERY

A multicentre retrospective study was carried out to analyse short- an d long-term results of 787 pancreatic resections performed for cancer between 1982 and 1988. The postoperative mortality rate was 10 per cen t and the morbidity rate 35 per cent. Age above 70 years and systemic organ failure independently influenced operative mortality. In patient s surviving more than 30 days the median survival was 12.3 months and the actuarial survival rate at 5 years 12 per cent. The 5-year surviva l rate was lower for patients with lymph node involvement than for tho se without (4 versus 20 per cent, P = 0.001). The operative mortality rate was higher after total pancreatectomy than pancreatoduodenectomy (17 versus 8 per cent, P = 0.015). The median survival time and 5-year survival rate after total pancreatectomy and pancreatoduodenectomy we re II versus 14 months and 3 versus 15 per cent respectively. Of the c linical and pathological factors studied, location of the tumour in th e left pancreas was most strongly related to survival, with no survivo rs at 4 years. These results suggest that resection should be avoided in patients over 70 years old with systemic organ failure. Pancreato d uodenectomy remains the best procedure for resection, total pancreatec tomy being performed only in patients with multifocal carcinoma or tho se in whom a safe pancreatic anastomosis cannot be constructed.