Prognosis of Resected Pancreatoduodenal Cancers

Kazuhide Ura, Toshifumi Eto, Teiji Matsumoto, Tohru Segawa, Hikaru Fujioka, Masazumi Terada, Koichi Motojima, Kunihide Izawa*, Tsukasa Tsunoda, Ryoichi Tsuchiya**

Second Department of Surgery and Department of Emergency*, Nagasaki University School of Medicine, Shimane Medical College**

The outcome and prognostic factors of 114 cases of resected pancreatoduodenal cancers including 55 in the pancreas head, 34 in the papilla of Vater, and 25 in the lower bile duct from October 1969 through October 1990, were studied. The average ages of patients with carcinoma of the head of the pancreas, carcinoma of the papilla Vater, and carcinoma of the lower bile duct were 64.0±117, 59.3±12.3 and 62.1±11.5 respectively. The cumulative survival of patients with carcinoma of pancreas head was significantly shorter than those with carcinoma of the papilla of Vater or the lower bile duct (p<0.01). There were no significant differences in survival curves between carcinoma of the papilla of Vater and the lower bile duct. One-year survival rates for carcinoma of the pancreas head, papilla of Vater, and lower bile duct were 40%, 64%, 72% respectively, and the 5-year survival rates were 8%, 31%, 44% respectively. However, in advanced cases, especially in stage III, the cumulative survival curve for carcinoma of the papilla of Vater was almost the same as that for carcinoma of the pancreas head, and significantly worse than for carcinoma of the low bile duct. The most prognostic factor of carcinoma of the pancreas head was invasion to the retroperitoneal tissue (p<0.05). The most prognostic factor for carcinoma of the papilla of Vater was invasion to the pancreas (p<0.001), although the presence or absence of duodenal invasion (p<0.05) or lymph node metastasis (p<0.01) had significant influence on the outcodme. Carcinoma of the lower bile duct had the best outcome in this study, and there were no significant differences in cumulative survival curves in the presence or absence of each staging factor.

Key words
pancreatoduodenal cancer, prognosis of the resected cases, staging factors of pancreatoduodenal cancer

Reprint requests
Kazuhide Ura The Second Department of Surgery, Nagasaki University School of Medicine
7-1 Sakamoto-machi, Nagasaki, 852 JAPAN

Accepted
May 8, 1991

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