An Evaluation of Extended Radical Pancreatectomy for Carcinoma of the Head of the
Pancreas Based on the Clinicopathologic Analysis and Quality of Life

Masato Kayahara, Takukazu Nagakawa*, Toshiaki Yasui, Hirohisa Kitagawa, Tetsuo Ohta, Takashi Fujimura, Gennichi Nishimura and Koichi Miwa

Second Department of Surgery, Kanazawa University, School of Medicine
*Department of Nursing, Kanazawa University, School of Health Science

To evaluate the results of extended pancreatectomy for pancreatic cancer, a total of 78 patients with carcinoma of the head of the pancreas were analyzed on the basis of a clinicopathologic study and quality of life. The incidence of nodal involvement was 77%. Rates of metastases to Group 14 and 16 were 31% and 18%, respectively. Perigastric lymph nodes were involved in three patients. Patients with lymph node involvement fared significantly worse than those without lymph node involvement (43%vs. 6% at 5 years). The category of tumor at the surgical margin (ew) was also an important prognostic factor. Although the 5-year survival rate for patients with a negative surgical margin was 36%, all patients with a positive surgical margin died within 3 years. Postoperative quality of life was evaluated by changes in body weight serum albumin levels, total cholesterol, and so on. Although diarrhea was one of the most important postoperative problems, the nutritional status was almost satisfactory. These results indicate that extended radical pancreatectomy is needed in the majority of patients with pancreatic carcinoma.

Key words
nodal involvement of pancreatic cancer, negative surgical margin, extended radical pancreatectomy

Reprint requests
Masato Kayahara Second Department of Surgery, Kanazawa University School of Medicine 13-1 Takaramachi, Kanazawa, 920-8641 JAPAN

Accepted
July 28, 1999

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