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A margin-negative R0 resection accomplished with minimal postoperative complications is the surgeon’s contribution to long-term survival in pancreatic cancer

Authors
  • Howard, Thomas J.1
  • Krug, Joseph E.1
  • Yu, Jian1
  • Zyromski, Nick J.1
  • Schmidt, C. Max1
  • Jacobson, Lewis E.1
  • Madura, James A.1
  • Wiebke, Eric A.1
  • Lillemoe, Keith D.1
  • 1 Indiana University School of Medicine, From the Pancreas Research Group, Department of Surgery, Indianapolis, Indiana , Indianapolis
Type
Published Article
Journal
Journal of Gastrointestinal Surgery
Publisher
Springer-Verlag
Publication Date
Oct 01, 2006
Volume
10
Issue
10
Pages
1338–1346
Identifiers
DOI: 10.1016/j.gassur.2006.09.008
Source
Springer Nature
Keywords
License
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Abstract

Pancreatic cancer has a poor prognosis with complete surgical resection being the only therapy to offer a realistic chance for long-term survival. The aim of this study is to identify surgery-related variables that influence long-term survival. Between 1990 and 2002, 226 consecutive patients (mean age of 64 ± 11 years) had resection for pancreatic adenocarcinoma. Prognostic variables in these patients were analyzed using univariate and multivariate analysis. Two hundred four patients (90%) had pancreaticoduodenectomy, 13 patients (6%) had distal pancreatectomy, and 9 patients (4%) had a TP. Stage I disease was present in 50 (22%), stage II disease in 170 (75%), and stage III disease in 6 (3%). R0 resections were achieved in 70%. Operative morbidity was 36% and 30-day mortality was 6%. Actual 1-year, 3-year, and 5-year survival rates were 49% (n=111), 14% (n=31), and 4% (n=9). Using multivariate analysis: tumor size, tumor differentiation, obtaining an R0 resection, and lack of postoperative complications were variables associated with long-term survival. Long-term survival in patients with pancreatic cancer after resection remains poor. Achieving a margin negative resection (R0) with no postoperative complications are prognostic variables that can be affected by the surgeon.

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