Treatment Strategy for Invasive Duct Cell Cancer of the Pancreas: Study in 15 Patients who Survived for 5 Years

Shin Takahashi, Kouichi Aiura, Junichi Saitou, Sigeo Hayatsu, Masaki Kitajima and Yosirou Ogata

Department of Surgery, Keio University school of Medicine

Invasive ductal cancer of the pancreas was resected in 170 patients between September 1974 and December 1997, and clinical manifestations, operative procedures, pathological findings, and treatment methods were investigated as features characterizing the 15 patients who had survived for 5 years. The operative procedure was pancreatoduodenectomy in 13 patients, and total pancreatectomy and distal pancreatectomy in one patient each. Portal resection was performed in 6 patients, 5 of the PD patients and the 1 TP patient. The JPS stage was stage I in 1 patient, stage II in 4 patients, stage III in 3 patients, stage IVa in 6 patients and stage IVb in 1 patient. All of the patients underwent macroscopically curative resection, but three of the patients were microscopically invasion (+) at the cut surface of the tissue around the pancreas. Treatment modalities consisted of surgery alone in 4 cases, chemotherapy in 3 cases, extracorporeal radiation in 2 cases, and in the most recent cases, portal catheterization in 6 patients and intraoperative radiation in 4 of these 6. At the present time, we think that if macroscopically curative surgery is initially possible, even in advanced cases, such as portal invasion cases and lymph node-positive cases beyond the peripancreatic nodes, it should be performed in the hope of achieving a histologically curative resection.

Key words
invasive ductal carcinoma of the pancreas, 5-year survivor, pancreatoduodenectomy

Reprint requests
Shin Takahashi Department of Surgery, Keio University School of Medicine 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-0016 JAPAN

Accepted
January 27, 1999

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