Evaluation of the Extended Radical Operation for Pancreatic Cancer

Toshiaki Nakasako, Fujio Hanyu, Toshihide Imaizumi, Mamoru Suzuki, Nobuhiko Harada, Takashi Hatori, Toshio Arai, Tetsuya Hirose, Akira Fukuda, Shigeru Munakata

Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical College

Two hundred eighty-four patients who had extended radical operation for ductal adenocarcinoma of the pancreas were studied to evaluate the effectiveness of the extended radical operation. They were divided into two groups, with or without an extended radical operation. Morbidity after the extended radical operation in the patients with carcinoma of the head and the body of the pancreas were 19% and 29%, respectively. Mortality after extended radical operations was 4% and 0%, respectively. Thus the extended radical operation was performed safely. Curability in the patients with carcinoma of the head and the body of the pancreas was 49% and 71%, respectively. Nine patients who had the extended radical operation for the carcinoma of the head of the pancreas survived longer than 5 years postoperatively. The mean survival time was prolonged in the patients who had the extended radical operation for carcinoma of the body of the pancreas. No histological difference was noted between the two groups. Stage III or IV tumors in the patients who had the extended radical operation for carcinoma of the head and the body of the pancreas were found in 85% and 95% or more, respectively. As the majority of the patients with pancreatic carcinoma showed serious invasion, retroperitoneal invasion and lymphnode involvement, the extended radical operation is indicated. And however, as curability was 0% and the survival rate was 8% at 1 year and 0% at 2 years in the patients who had clinical stage IV tumors, in those patients an extended radical operation is not be indicated. Retroperitoneal recurrence and liver metastasis occurred at a high incidence even after extended radical operations. Multidisciplinary therapy is indicated for those patients.

Key words
pancreatic cancer, extended radical operation, recurrence

Reprint requests
Toshiaki Nakasako Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical College
8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162 JAPAN

Accepted
December 9, 1992

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