An Evaluation of Surgical Treatment for Pancreatic Adenocarcinoma

Hiroyasu Imayama, Hisafumi Kinoshita, Kouji Okuda, Masao Hara, Shuuichi Fukuda,
Takenori Sakai, Shuuichi Sajima, Mitsuo Hashimoto, Naofumi Eriguchi and Toshimichi Nakayama^*

Department of Surgery, Kurume University School of Medicine, ST. Mary's Junior College^*

We investigated standards for determining surgical treatment of pancreatic cancer accordng to the surgical results in Kurume University Hospital from 1965 to 1997, using the classification of pancreatic carcinoma (JPS). A significant difference (p< 0.001) was noted in the cumulative survival rate between the resection and the non-resection groups. Furthermore, the 50% survival time and the 1- and 3-year survival rates were 1.00 years, 50.0%, and 13.4%in trhe resection group, and 0.39 years, 10.6%, and 0.7% in the non-resection group, respectively. As for Stage 4b, no difference in the survival rate between the resected and the non-resected cases was found. The survival rates varied greatly with the degree of curability, so that, long-term survival required a curability of A or B. There was no difference in the survival rate according to lymphnode dissection degree and intraoperative radiation therapy. Therefore, we concluded the following: 1) in stage 1, 2 and 3, extended operation is required; 2) in stage 4a, if extended operation obtains a curability more than B, the pancreas should be resected, or else should be resected; 3) in stage 4b, another therapy is needed.

Key words
surgical result of pancreatic adenocarcinoma, extended operation, intraoperative radiation therapy

Reprint requests
Hiroyasu Imayama Department of Surgery, Kurume University School of Medicine 67 Asahi-machi, Kurume, 830-0011 JAPAN

Accepted
January 27, 1999

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