Long-Term Survival (5-20 Years) After Pancreatectomy for Pancreatic Ductal Adenocarcinoma

Abstract

Pancreatic duct adenocarcinoma can be cured, and long-term survival after R0 curative surgery has become a reality. Long-term survivors did not fulfil the ideal prognostic criteria and even presented with advanced stage.

Cardiopulmonary Exercise Testing for Preoperative Risk Assessment before Pancreaticoduodenectomy for Cancer

“…Surgical resection is the standard of care for patients with tumours confined to the head of the pancreas [1][2][3]. An increasing number of reports attest that pancreaticoduodenectomy can be performed with low operative mortality [2,4].…”

Stromal galectin-1 expression is associated with long-term survival in resectable pancreatic ductal adenocarcinoma

“…[4][5][6][7][8][9][10][11][12][13] Clinicopathological features associated with improved survival at 5 years post-resection include small tumor size (< 2 cm), negative lymph node status, negative resection margin (i.e., R0), absence of angiolymphatic and perineural invasion, and low grade of differentiation. Relatively longer (i.e., ≥ 5 y) survival after surgery for PDAC has been increasing for the last two decades, largely due to centralization of surgery to high-volume (i.e., expert) centers.…”

“…11,[19][20][21] Nonetheless, there are a handful of published studies which have identified ≥ 10-y survivors of histologically validated PDAC, usually at a frequency less than 5% in most series. 4,5,12,22 Of note, these cohorts of VLTS patients not only include those with small T1, node-negative (N0) tumors, but also patients with more aggressive features, including T2-T4 sized lesions, and lymph node involvement. 5 This would suggest that the basis of VLTS in PDAC extends beyond simply resecting node-negative localized cases, but might indicate an intrinsic molecular phenotype of such tumors.…”

Short-Term Outcomes of Extended Pancreatectomy: A Single-Surgeon Experience

“…Underpinning this trend is the fact that pancreatic cancer tends to present late and that complete surgical resection still offers the best chance of disease-specific survival [3,14,15]. Indeed, various papers have reported improved 5-year survival rates of between 12% and as high as 27% after resection in recent years [16][17][18][19].…”

“…Various studies have showed improved survival [28], with some quoting comparable 5-year rates of [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35].5% [29][30][31]. In contrast, other studies have demonstrated a significant difference in favor of the standard resection group.…”