Factors Associated with Survival after Surgical Resection in Chinese Patients with Ductal Adenocarcinoma of the Pancreatic Head

Abstract

Objectives: The aim of this cohort study was to investigate clinical outcome and prognostic factors after resection for ductal adenocarcinoma of the pancreatic head. Methods: 134 patients with pancreatic cancer undergoing curative resection (R0) between 1997 and 2002 were included in this study. Univariate and multivariate analyses were performed to examine factors affecting clinical outcome and recurrence. Results: Surgical procedures consisted of 58 (43.3%) extended pancreaticoduodenectomies, 47 (35.1%) pancreaticoduodenectomies and 29 (21.6%) pylorus-preserving pancreaticoduodenectomies. Results showed that 81.3% patients had a recurrence during the study period, mainly retroperitoneal recurrence in combination with distant metastasis (53.7%). The median survival time was 24.67 months. The 1-, 3- and 5-year overall disease-free survival rates for the study population were 52, 23 and 19%, respectively. Conclusions: The results from proportional hazard analysis suggest that preoperative abdominal and/or back pain, tumor size >2 cm, lymph node involvement and vascular invasion were significant predictors for poor survival.

Vascular Invasion in Infiltrating Ductal Adenocarcinoma of the Pancreas Can Mimic Pancreatic Intraepithelial Neoplasia

“…11 Second, even if the diagnosis of invasive carcinoma is correctly established, PanIN-like vascular invasion is important to recognize because, just as is true for more conventional vascular invasion, it is a poor prognostic indicator (Figure 5). 1,6,8,9,12,15 …”

External Beam Radiotherapy Plus 24-Hour Continuous Infusion of Gemcitabine in Unresectable Pancreatic Carcinoma: Long-Term Results of a Phase II Study

“…Since gemcitabine was recognized to be more effective in terms of clinical benefit compared with 5-FU in advanced pancreatic adenocarcinoma (9), many trials experimenting gemcitabine-based CT-RT have been carried out (22)(23)(24)(25)(26)(27)(28)(29)(30). However, this combined modality seemed to be associated with concerning gastrointestinal toxicities, especially when large fields were employed (22,24).…”

“…First, the majority of patients enrolled presented a good performance status (ECOG 0-1: 77.5%), widely recognized as a favorable prognostic factor (30,31); furthermore, most patients (82.5%) had head tumors, which are more responsive to gemcitabine and have a better prognosis compared with body/tail tumors (32). However, the clinical response rate seemed to be limited, with an overall response rate of 30%.…”

Improvement in Treatment and Outcome of Pancreatic Ductal Adenocarcinoma in North China

“…1,12 Though highly specialized centers for pancreatic cancers were built up with skilled surgical oncologists and experienced multimodality physicians, the improvement in treatment modalities and patients' outcomes have not yet been delineated. The purpose of this study is to investigate the decade-based improvement in diagnosis modalities and surgical treatment, and to compare the different outcomes in the same cancer center between two decades.…”