Korean J Med.
2000 Jun;58(6):651-656.
Analysis of resectability and survival in pancreatic cancer patients with vascular invasion
- Affiliations
-
- 1Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 2Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Abstract
- BACKGROUND
One of the major limitations of curative resection in pancreatic cancer
patients is local tumor extension to the mesenteric vessels. Thus, the purposes of our study
were (1) to assess the clinical value of contrast enhanced spiral CT in predicting the
resectability and survival of pancreatic cancer patients with suspicious vascular invasion
and (2) to assess the influence of curative resection on survival in these patients.
METHODS
Forty cases of the pancreatic cancer patients who were suspected of having involvement
of adjacent large vessels and subsequently underwent operation with curative intent were
enrolled in this study. Resectability and survival were correlated with CT findings such as
segment length, degree of encasement, type and number of vessel involved. Survival rate
was compared between curative and palliative resection groups. And survival was also
compared between resected and non-resected groups.
RESULTS
Of the 40 patients with
adenocarcinoma of the pancreas, 14 patients had curative resections, and 26 patients
had palliative resections. The probability of curative resection was higher in patients
with segment length less than 2 cm, compared with those with more than 2 cm. However,
there was no difference in survival between two groups. There were no differences
of resectability and survival according to the degree of encasement, type and number of
vessel involved. There were no difference in survival between curative and palliative resection
groups, and between resected and non-resected groups.
CONCLUSION
A survival benefit is not
achieved by curative resection in pancreatic cancer patients with vascular invasion.
So other non-operative treatments should be considered as effective tools prior to resection
in these patients.