Long-term and short-term survivors after pancreatectomy for pancreatic cancer

Out of 63 Japanese patients with pancreatic carcinoma who underwent surgica l resection, 8 short-term survivors who died within 3 months after resectio n and 6 long-term survivors who were alive for more than 3 years after rese ction were compared regarding 26 clinicopathological parameters. The 8 shor t-term survivors were significantly older than the 6 long-term survivors (6 3.7 versus 47.8 years, P = 0.0099). The mean peripheral lymphocyte count wa s significantly smaller in the short-term survivors than in the longterm su rvivors (1,212 versus 2,115/mu l, P = 0.0459). Operative blood loss was sig nificantly larger in the short-term survivors than in the long-term survivo rs (2,393 versus 1,043 g, P = 0.0157). The surgical margin was affected by malignant cells in 7 of the 8 short-term survivors, but in only 2 of the 6 long-term survivors (P = 0.0362). Of the 8 short-term survivors, 5 were in comprehensive stage IV and 3 in stage III, while 3 of the 6 long-term survi vors were in stage III, two in stage II, and one in stage I (P = 0.0487). A ll the 8 shortterm survivors were of the comprehensive curability C, while 3 of the 6 long-term survivors were of A, one B and the other two C (P = 0. 0239). Multiple regression analysis of these 6 profound factors showed that the peripheral lymphocyte count was an independent significant parameter t o differentiate the short-term and long-term survivors. These findings sugg est that, although the aggressive nature of pancreatic cancer has been acce pted, the clinical course after pancreatectomy would also depend upon the i mmunological state of the patient.