Prognosis Factors in Carcinoma of the Head of the Pancreas

Abstract

Background: Due to a low survival rate even after a R0 resection of cancer of the head of the pancreas, a strict indication for a pancreaticoduodenectomy seems to be sensible. We have therefore analyzed our patients for possible prognosis factors. Methods: In a retrospective trial the courses of disease of all patients (1981–1996) with resected histologically proven carcinoma of the head of the pancreas were analyzed. The following patient-specific parameters were evaluated and examined in a single or multivariate analysis of prognosis factors: age, gender, tumor size (T status), lymph node involvement (N status), dimension of resection, operation method, time of operation, morbidity, clinic lethality and survival rate. Results: Between 1981 and 1996, 500 patients with ductal adenocarcinoma of the head of the pancreas were treated surgically. The rate of resection increased from 32.1% (1981–1986) to 37.8% (1991–1996) whereas the mortality rate decreased from 13.3 to 7.3%. The 5-year survival rate after resection was 11.8% with a median survival time of 13.8 months. In a multivariate analysis, only small tumors (T1, p < 0.016), the R0 status (p < 0.017) and the resection had a significant influence on the survival rate. Conclusion: Prognosis factors in the treatment of pancreatic cancer were tumor size (T1), tumor resection and R0 status.

Influence of Resection Margins on Survival for Patients With Pancreatic Cancer Treated by Adjuvant Chemoradiation and/or Chemotherapy in the ESPAC-1 Randomized Controlled Trial

“…In a study of 75 resections using multivariate analysis, Millikan et al 37 reported that both blood transfusion and an R1 resection independently and significantly reduced long-term survival. On a similar note, Wenger et al, 38 in a study of 158 resections, reported that tumors larger than 2 cm in diameter and again R1 resections were associated independently with a significantly shorter survival.…”

German National Case Collection of Familial Pancreatic Cancer – Clinical-Genetic Analysis of the First 21 Families

“…At diagnosis, however, only 1/3 of patients have the chance of potentially curative resectability of PC. In over 80% of cases tumors measure larger than 2 cm in diameter with lymphnode secondaries [3][4][5]. In order to reduce mortality in this condition, a diagnosis program is required for the earliest possible identification of PC.…”

Pathological tumor size is an independent prognostic factor in pancreatic cancer patients undergoing curative resection followed by adjuvant chemotherapy with S-1

“…Therefore, it is important to identify prognostic factors for pancreatic cancer in order to select candidates for more aggressive treatment. Previously, clinicopathological factors, such as the tumor size and lymph node metastasis, were reported to be significant prognostic factors that may be used to predict survival in subjects with pancreatic cancer [3][4][5][6][7] . However, these reports only analyzed patients treated with surgery alone or surgery followed by adjuvant chemotherapy of unknown efficacy, as effective adjuvant chemotherapy regimens have not been verified in these patients.…”