Pancreatoduodenectomy for locally advanced or recurrent colon cancer: Report of two cases

A 66-year-old man, who had ascending colon cancer which invaded the duodenu m, pancreas, and superior mesenteric vein, underwent a curative resection i ncluding an extended right hemicolectomy, pylorus-preserving pancreatoduode nectomy, and a partial resection of the superior mesenteric vein. The patho logical examination revealed adenocarcinoma of the colon, which directly in vaded the duodenum and pancreas, thus causing duodenocolic fistula. Tumor i nfiltration to the superior mesenteric vein was not histologically proven. Two out of 40 lymph nodes were also involved. The patient is still alive an d disease-free 37 months after the operation. A 72-year-old man, with a his tory of surgery two previous times for ascending colon cancer and its recur rence, underwent a third operation including a resection of the former ileo colic anastomosis en bloc by means of a pylorus-preserving pancreatoduodene ctomy,vith a curative intent. The pathological examination revealed adenoca rcinoma of the colon, which directly invaded the duodenum and pancreas. Sev en out of 31 lymph nodes were also involved. The patient died of recurrence 24 months after the third operation. These two cases demonstrated the usef ulness of a resection of the colon en bloc by means of a pancreatoduodenect omy in patients with either locally advanced colon cancer or locally advanc ed recurrent colon cancer.