The prognostic significance of lymph node metastasis and intrapancreatic perineural invasion in pancreatic cancer after curative resection

To investigate the prognostic factors of pancreatic cancer, a retrospective analysis of 193 patients who underwent curative resection was conducted, O f the 193 patients, 38 (20%) survived for more than 5 years, the 5-year sur vival rates for stages I, II, III, and IV disease being 41%, 17%, 11%, and 6%, respectively. According to a multivariate analysis, lymph node metastas is, intrapancreatic perineural invasion, and portal vein invasion were sign ificant prognostic factors. Subsequently, a subgroup analysis concerning no dal metastasis and intrapancreatic perineural invasion mas performed in 126 patients with records of these histological findings. In the group of pati ents without nodal metastasis, the 5-year survival rate for those without p erineural invasion mas 75%,,whereas that for those with perineural invasion was 29%, the difference in survival of these subgroups being significant ( P < 0.02), In the group of patients with nodal metastasis, the 5-year survi val rate for those without perineural invasion mas 17%, while that for thos e with perineural invasion was 10%. The most favorable 5-year survival of 8 9% was observed in the subgroup of patients with stage I disease without pe rineural invasion. Thus, pancreatic adenocarcinoma categorized by the combi nation of these independent types of biological behavior showed 5-year surv ival rates ranging from very high to low, indicating that these two factors play an important role in the prognosis of this disease.