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Prognosis and feasibility of en-bloc vascular resection in stage II pancreatic adenocarcinoma

2010; Baishideng Publishing Group; Volume: 16; Issue: 8 Linguagem: Inglês

10.3748/wjg.v16.i8.997

2219-2840

Kamalesh Chakravarty,

Gastric Cancer Management and Outcomes

AIM:To establish the prognosis and feasibility of en-bloc vascular resection of stage Ⅱ pancreatic adenocarcinoma of the head and uncinate process. METHODS:We retrospectively analyzed 87 patients with stage Ⅱ pancreatic adenocarcinoma, who were subjected to pancreaticoduodenectomy (PD) and pylorus-preserving PD (PPPD) between 1996 and 2006 in Chang Gung Memorial Hospital, Taiwan.Twelve and 75 patients underwent PD/PPPD with and without resection of portal vein/superior mesenteric vein (PV/SMV), respectively. RESULTS:The overall 1-and 3-year survival rates of patients undergoing PD/PPPD with and without vascular resection were 50.0%and 16.7%, and 44.4% and 12.2%, respectively.Morbidity and mortality rates in the PV/SMV resection vs non-resection group were 50.0%and 0.0%, and 40.0% and 2.7%, respectively.In multivariate analysis, serum bilirubin, histological differentiation and adjuvant chemotherapy were independent prognostic factors that influenced survival. CONCLUSION:In stage Ⅱ adenocarcinoma of the pancreatic head and uncinate process, serum bilirubin, histological differentiation and adjuvant chemotherapy were independent prognostic factors, and en-bloc vascular resection is a feasible option in carefully selected patients.