A Clinical Study on Pancreatic Head Cancer

Park, Young Rae; Nah, Yang Won; Chang, Surk Hyo; Paik, In Wook; Lee, Hyuc ksang

Abstract

BACKGROUND/AIMS: Pancreatic head cancer has been characterized by a low resectability and poor survival rate. This study was conducted to examine the resectability and postoperative results of pancreatic head cancer.
METHODS
A retrospective study was performed for 45 patients with pancreatic head cancer treated at our department from 1988 through 1997.
RESULTS
The cancer was prevalent in the 6th and 7th decades (71.1%) of life. The male-to-female ratio was 1.7:1. Ninety-five percent of the patients was in either TNM stage III or IV. Pancreatoduodenectomy was executed in 8 patients (17.8%) without operative mortality or anastomotic leakage. Out of 26 patients who under went biliary bypass surgery, 24 were subjected to concomitant gastrojejunostomy. Eleven patients (24.4%) received non-operative management. Actuarial survival rates of 1 and 4 years after pan creatoduodenectomy were 75.0% and 45.0%, respectively. The median survival after pancreatoduo denectomy was 27 months, which was significantly longer than those after bypass surgery (8 months or after non-operative treatment (4 months)(p<0.0005).
CONCLUSIONS
Pancreatoduodenectomy can be safely performed for pancreatic head cancer without operative mortality or major complication. Early detection and the development of more promising adjuvant therapies are required to improve resectability and to prolong survival after resection of pancreatic head cancer.