Extended Lymphadenectomy for Pancreatic Cancer -An Evaluation of the Curability and Postoperative Quality of Life-

Osamu Ishikawa, Hiroaki Ohigashi, Shingi Imaoka, Masao Kameyama, Yo Sasaki, Toshiyuki Kabuta, Hiroshi Furukawa, Takeshi Iwanaga

Department of Surgery, The Center for Adult Diseases, Osaka

This retrospective study attempted to determine the operative curability and postoperative quality of life in the patients who had received an extended pancreatectomy for carcinoma of the pancreas. Among 102 patients who tolerated pancreatectomies, lymph-adenectomy was limited to the area immediately adjacent to the cancer lesion in 39 patients (R1), while it was extended to the n2-area (in the classification of the Japanese Pancreas Society) together with the neighboring connective tissue in the other 63 patients (R2α). Though there was no significant difference in the background factors between the two groups, the 3-year survival rates were 10% and 35%, respectively (p<0.05). The R2α-group, but not the R1-group, had 3-year survivors even among the patients with nodal involvement, retroperitoneal invasion or portal vein-invasion. However, there were few 3-year survivors among the patients whose cancers were more than 4 cm in diameter, metastasized to the n2-area, or widely invaded the portal vein. In the 3-year survivors of the R2α-group, neither both body weight nor performance status had been recovered by one year after surgery. On the other hand, the mean survival period was 13 months in the patients who died of cancer recurrence. Therefore, The R2α-procedure is recommended for the less advanced cases, with very careful management.

Key words
pancreas cancer, extended lymphadenectomy, quality of life

Reprint requests
Osamu Ishikawa Department of Surgery, The Center for Adult Diseases, Osaka
1-3-3 Nakamichi, Higashinari-ku, Osaka, 537 JAPAN

Accepted
July 6, 1992

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