Regional Pancreatectomy in Pancreas Cancer

Lee, Jung Joon; Han, Duck Jong; Jang, Hyuck Jai; Kim, Song Cheol; Park, Kwang Min; Lee, Young Joo; Lee, Sung Gyu; Yoon, Gil Suk

Abstract

BACKGROUND/AIMS: Low resectability and poor long-term survival due to distant metastasis or locally advanced lesion which precludes curative resection, characterize pancreatic adenocarcinoma. While regional pancreatectomy improves resection rate in a locally advanced lesion, this procedure has been reported to involve high mortality and morbidity without improving long-term survival. We compared this procedure with other pancreatectomy and non-resection procedures for pancreas cancer.
METHODS
One hundred sixty two patients who were operated because of pancreas adenocarcinoma from May 1989 to September, 1997 were grouped into non-regional pancreatectomy group (NRP, n=32), re gional pancreatectomy group (RP, n=37), and non-resection group (NR, n=93). Their clinical features postoperative morbidity and mortality, and prognostic factors were analyzed retrospectively.
RESULTS
Out of 162 patients, 69 (42.6%) underwent resection. Overall morbidity was 25.0% in NRP group and 40.5% in RP group (p=0.93). There was no operative mortality in both groups. One-year surviva rate was 50.7% in NRP group, 30.0% in RP group, and 11.6% in NR group (p=0.03). Factors affecting prognosis were tumor size (p=0.01), lymph node status (p=0.02), and tumor stage (p=0.02)
CONCLUSIONS
Regional pancreatectomy improved resectability and survival rate in the case with locally advanced lesion. Additionally, its morbidity and mortality were similar to those of classica resection procedures.