Pancreatic carcinoma

Reappraisal of surgical experiences in one Japanese University Hospital

Koji Yamaguchi, Shuji Shimizu, Kazunori Yokohata, Hirokazu Noshiro, Kazuo Chijiiwa, Masao Tanaka

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

BACKGROUND/AIMS: Even with the recent advances of diagnostic and therapeutic modalities, the clinical course of patients with pancreatic cancer remains dismal. Five-year survivors are rare, cure is exceptional, and the operative mortality rate is significant. In this study, univariate and multivariate retrospective analyses were performed with regard to the prognostic parameters to clarify the problems in order to improve survival rates after surgical resection. METHODOLOGY: Clinical courses of 60 Japanese patients with pancreatic cancer who underwent surgical resection in one Japanese University Hospital were reviewed to scrutinize the influence of 22 prognostic (9 host-side, 5 operative and 8 tumor-side) factors. A special reference was made on intraoperative radiation therapy, portal vein resection, lymph node dissection around the aorta, and conventional pancreatoduodenectomy versus pylorus-preserving pancreatoduodenectomy in pancreatic head cancer. RESULTS: Univariate analysis showed that operation time, comprehensive stage, comprehensive curability, histopathologic grade of differentiation and histopathologic venous invasion were statistically significant factors. Multivariate Cox regression analysis regarding the 5 profound factors showed that histopathologic grade of differentiation and histopathologic venous invasion were independently significant factors. The 1- and 3-year survival rates of 18 patients with intra-operative radiation therapy were 56% and 39%, while those of 36 patients without intra-operative radiation therapy were 54% and 18%. The 1- and 3-year survival rates of 43 patients with PVO,1 were 58% and 28%, while those of 17 with PV2,3 were 50% and 10%. Three patients with PV2 in 1 and PV3 in 2 underwent a portal vein resection. Two of the 3 patients were dead from liver metastasis 3 and 5 months after a surgical resection of liver metastasis. The 1- and 3-year survival rates of 17 with radical lymph node dissection including the para-aortic area were 61% and 26%, while those of 27 without para-aortic lymph node dissection were 66% and 25%. Of the 17 patients, the para-aortic lymph node was metastasized in 1 patient. The 1- and 3-year survival rates of 31 with pancreatoduodenectomy were 53% and 18%, while the 1- and 3-year survival rates with pylorus preserving pancreatoduodenectomy were 68% and 28%, respectively. CONCLUSIONS: These findings suggest that the clinical outcome after surgical resection of pancreatic carcinoma depends on tumor-side factors not operative parameters or host-side parameters. The clinical course seems to rely upon the nature of pancreatic cancer not upon the operative procedure.

Original languageEnglish
Pages (from-to)3257-3262
Number of pages6
JournalHepato-Gastroenterology
Volume46
Issue number30
Publication statusPublished - 1999

Fingerprint

Pancreaticoduodenectomy
Survival Rate
Pancreatic Neoplasms
Lymph Node Excision
Radiotherapy
Pylorus
Portal Vein
Neoplasm Metastasis
Pancreatic Carcinoma
Liver
Operative Surgical Procedures
Head and Neck Neoplasms
Survivors
Aorta
Neoplasms
Multivariate Analysis
Lymph Nodes
Regression Analysis
Mortality
Therapeutics

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Yamaguchi, K., Shimizu, S., Yokohata, K., Noshiro, H., Chijiiwa, K., & Tanaka, M. (1999). Pancreatic carcinoma: Reappraisal of surgical experiences in one Japanese University Hospital. Hepato-Gastroenterology, 46(30), 3257-3262.

Pancreatic carcinoma : Reappraisal of surgical experiences in one Japanese University Hospital. / Yamaguchi, Koji; Shimizu, Shuji; Yokohata, Kazunori; Noshiro, Hirokazu; Chijiiwa, Kazuo; Tanaka, Masao.

In: Hepato-Gastroenterology, Vol. 46, No. 30, 1999, p. 3257-3262.

Research output: Contribution to journalArticle

Yamaguchi, K, Shimizu, S, Yokohata, K, Noshiro, H, Chijiiwa, K & Tanaka, M 1999, 'Pancreatic carcinoma: Reappraisal of surgical experiences in one Japanese University Hospital', Hepato-Gastroenterology, vol. 46, no. 30, pp. 3257-3262.
Yamaguchi, Koji ; Shimizu, Shuji ; Yokohata, Kazunori ; Noshiro, Hirokazu ; Chijiiwa, Kazuo ; Tanaka, Masao. / Pancreatic carcinoma : Reappraisal of surgical experiences in one Japanese University Hospital. In: Hepato-Gastroenterology. 1999 ; Vol. 46, No. 30. pp. 3257-3262.
@article{cd80c500e2374adcabddea9a76b5ee09,
title = "Pancreatic carcinoma: Reappraisal of surgical experiences in one Japanese University Hospital",
abstract = "BACKGROUND/AIMS: Even with the recent advances of diagnostic and therapeutic modalities, the clinical course of patients with pancreatic cancer remains dismal. Five-year survivors are rare, cure is exceptional, and the operative mortality rate is significant. In this study, univariate and multivariate retrospective analyses were performed with regard to the prognostic parameters to clarify the problems in order to improve survival rates after surgical resection. METHODOLOGY: Clinical courses of 60 Japanese patients with pancreatic cancer who underwent surgical resection in one Japanese University Hospital were reviewed to scrutinize the influence of 22 prognostic (9 host-side, 5 operative and 8 tumor-side) factors. A special reference was made on intraoperative radiation therapy, portal vein resection, lymph node dissection around the aorta, and conventional pancreatoduodenectomy versus pylorus-preserving pancreatoduodenectomy in pancreatic head cancer. RESULTS: Univariate analysis showed that operation time, comprehensive stage, comprehensive curability, histopathologic grade of differentiation and histopathologic venous invasion were statistically significant factors. Multivariate Cox regression analysis regarding the 5 profound factors showed that histopathologic grade of differentiation and histopathologic venous invasion were independently significant factors. The 1- and 3-year survival rates of 18 patients with intra-operative radiation therapy were 56{\%} and 39{\%}, while those of 36 patients without intra-operative radiation therapy were 54{\%} and 18{\%}. The 1- and 3-year survival rates of 43 patients with PVO,1 were 58{\%} and 28{\%}, while those of 17 with PV2,3 were 50{\%} and 10{\%}. Three patients with PV2 in 1 and PV3 in 2 underwent a portal vein resection. Two of the 3 patients were dead from liver metastasis 3 and 5 months after a surgical resection of liver metastasis. The 1- and 3-year survival rates of 17 with radical lymph node dissection including the para-aortic area were 61{\%} and 26{\%}, while those of 27 without para-aortic lymph node dissection were 66{\%} and 25{\%}. Of the 17 patients, the para-aortic lymph node was metastasized in 1 patient. The 1- and 3-year survival rates of 31 with pancreatoduodenectomy were 53{\%} and 18{\%}, while the 1- and 3-year survival rates with pylorus preserving pancreatoduodenectomy were 68{\%} and 28{\%}, respectively. CONCLUSIONS: These findings suggest that the clinical outcome after surgical resection of pancreatic carcinoma depends on tumor-side factors not operative parameters or host-side parameters. The clinical course seems to rely upon the nature of pancreatic cancer not upon the operative procedure.",
author = "Koji Yamaguchi and Shuji Shimizu and Kazunori Yokohata and Hirokazu Noshiro and Kazuo Chijiiwa and Masao Tanaka",
year = "1999",
language = "English",
volume = "46",
pages = "3257--3262",
journal = "Acta hepato-splenologica",
issn = "0172-6390",
publisher = "H.G.E. Update Medical Publishing Ltd.",
number = "30",

}

TY - JOUR

T1 - Pancreatic carcinoma

T2 - Reappraisal of surgical experiences in one Japanese University Hospital

AU - Yamaguchi, Koji

AU - Shimizu, Shuji

AU - Yokohata, Kazunori

AU - Noshiro, Hirokazu

AU - Chijiiwa, Kazuo

AU - Tanaka, Masao

PY - 1999

Y1 - 1999

N2 - BACKGROUND/AIMS: Even with the recent advances of diagnostic and therapeutic modalities, the clinical course of patients with pancreatic cancer remains dismal. Five-year survivors are rare, cure is exceptional, and the operative mortality rate is significant. In this study, univariate and multivariate retrospective analyses were performed with regard to the prognostic parameters to clarify the problems in order to improve survival rates after surgical resection. METHODOLOGY: Clinical courses of 60 Japanese patients with pancreatic cancer who underwent surgical resection in one Japanese University Hospital were reviewed to scrutinize the influence of 22 prognostic (9 host-side, 5 operative and 8 tumor-side) factors. A special reference was made on intraoperative radiation therapy, portal vein resection, lymph node dissection around the aorta, and conventional pancreatoduodenectomy versus pylorus-preserving pancreatoduodenectomy in pancreatic head cancer. RESULTS: Univariate analysis showed that operation time, comprehensive stage, comprehensive curability, histopathologic grade of differentiation and histopathologic venous invasion were statistically significant factors. Multivariate Cox regression analysis regarding the 5 profound factors showed that histopathologic grade of differentiation and histopathologic venous invasion were independently significant factors. The 1- and 3-year survival rates of 18 patients with intra-operative radiation therapy were 56% and 39%, while those of 36 patients without intra-operative radiation therapy were 54% and 18%. The 1- and 3-year survival rates of 43 patients with PVO,1 were 58% and 28%, while those of 17 with PV2,3 were 50% and 10%. Three patients with PV2 in 1 and PV3 in 2 underwent a portal vein resection. Two of the 3 patients were dead from liver metastasis 3 and 5 months after a surgical resection of liver metastasis. The 1- and 3-year survival rates of 17 with radical lymph node dissection including the para-aortic area were 61% and 26%, while those of 27 without para-aortic lymph node dissection were 66% and 25%. Of the 17 patients, the para-aortic lymph node was metastasized in 1 patient. The 1- and 3-year survival rates of 31 with pancreatoduodenectomy were 53% and 18%, while the 1- and 3-year survival rates with pylorus preserving pancreatoduodenectomy were 68% and 28%, respectively. CONCLUSIONS: These findings suggest that the clinical outcome after surgical resection of pancreatic carcinoma depends on tumor-side factors not operative parameters or host-side parameters. The clinical course seems to rely upon the nature of pancreatic cancer not upon the operative procedure.

AB - BACKGROUND/AIMS: Even with the recent advances of diagnostic and therapeutic modalities, the clinical course of patients with pancreatic cancer remains dismal. Five-year survivors are rare, cure is exceptional, and the operative mortality rate is significant. In this study, univariate and multivariate retrospective analyses were performed with regard to the prognostic parameters to clarify the problems in order to improve survival rates after surgical resection. METHODOLOGY: Clinical courses of 60 Japanese patients with pancreatic cancer who underwent surgical resection in one Japanese University Hospital were reviewed to scrutinize the influence of 22 prognostic (9 host-side, 5 operative and 8 tumor-side) factors. A special reference was made on intraoperative radiation therapy, portal vein resection, lymph node dissection around the aorta, and conventional pancreatoduodenectomy versus pylorus-preserving pancreatoduodenectomy in pancreatic head cancer. RESULTS: Univariate analysis showed that operation time, comprehensive stage, comprehensive curability, histopathologic grade of differentiation and histopathologic venous invasion were statistically significant factors. Multivariate Cox regression analysis regarding the 5 profound factors showed that histopathologic grade of differentiation and histopathologic venous invasion were independently significant factors. The 1- and 3-year survival rates of 18 patients with intra-operative radiation therapy were 56% and 39%, while those of 36 patients without intra-operative radiation therapy were 54% and 18%. The 1- and 3-year survival rates of 43 patients with PVO,1 were 58% and 28%, while those of 17 with PV2,3 were 50% and 10%. Three patients with PV2 in 1 and PV3 in 2 underwent a portal vein resection. Two of the 3 patients were dead from liver metastasis 3 and 5 months after a surgical resection of liver metastasis. The 1- and 3-year survival rates of 17 with radical lymph node dissection including the para-aortic area were 61% and 26%, while those of 27 without para-aortic lymph node dissection were 66% and 25%. Of the 17 patients, the para-aortic lymph node was metastasized in 1 patient. The 1- and 3-year survival rates of 31 with pancreatoduodenectomy were 53% and 18%, while the 1- and 3-year survival rates with pylorus preserving pancreatoduodenectomy were 68% and 28%, respectively. CONCLUSIONS: These findings suggest that the clinical outcome after surgical resection of pancreatic carcinoma depends on tumor-side factors not operative parameters or host-side parameters. The clinical course seems to rely upon the nature of pancreatic cancer not upon the operative procedure.

UR - http://www.scopus.com/inward/record.url?scp=0032762714&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032762714&partnerID=8YFLogxK

M3 - Article

VL - 46

SP - 3257

EP - 3262

JO - Acta hepato-splenologica

JF - Acta hepato-splenologica

SN - 0172-6390

IS - 30

ER -