DUCTAL ADENOCARCINOMA OF THE PANCREAS - CLINICOPATHOLOGICAL FEATURES AND SURVIVAL

Aims and Background: The prognosis after surgical resection for pancre atic cancer has not been clearly defined because conflicting results h ave been reported. Methods: Fifty-five patients who underwent surgical resection for pancreatic: carcinoma between 1970 and 1987 were retros pectively reviewed to determine factors influencing long-term survival . Results: The actuarial 5-year survival rate for all 55 patients was 12.5 %. Type of operation, tumor stage, direct extension into adjacent organs, grading and lymph node involvement were found to significantl y influence survival. Age, sex, tumor site, size, invasion into peripa ncreatic tissue, invasion of lymphatic vessels and small veins, perine ural infiltration, tumor necrosis, round cell infiltrate at the tumor margin, associated chronic pancreatitis, and atypia of pancreatic duct al epithelium demonstrated no predictive capacity. No 5-year survival was observed among the patients who underwent vascular resection. Thre e of 9 patients who underwent left-sided pancreatectomy for cancer of the tail of the pancreas survived more than 5 years. Multivariate anal ysis confirmed that lymph node involvement, moderate-poor histologic t umor differentiation, and treatment with total pancreatectomy were sig nicantly associated with a worse prognosis. Conclusions: Lymph node st atus, grading of the tumor and type of operation have a significant im pact on prognosis in resected pancreatic cancer.