Is extended resection for adenocarcinoma of the body or tail of the pancreas justified? Journal Article
| Authors: | Shoup, M.; Conlon, K. C.; Klimstra, D.; Brennan, M. F. |
| Article Title: | Is extended resection for adenocarcinoma of the body or tail of the pancreas justified? |
| Abstract: | Patients with body or tail tumors of the pancreas often have contiguous organ involvement or portal-splenic confluence adherence requiring extensive resection in order to obtain grossly negative margins. The aim of this study was to determine whether long-term survival is possible after contiguous organ or portal vein resection in patients with adenocarcinoma of the body or tail of the pancreas. Between 1983 and 2000, a total of 513 patients with adenocarcinoma of the body or tail of the pancreas were identified from a prospective database. Distal pancreatectomy with or without splenectomy was performed in 57 patients (11%). Extended resection was necessary in 22 patients (39%): 14 (64%) for contiguous organ involvement and eight (36%) for portal vein resection Estimated blood loss, blood transfused, and length of hospital stay were significantly greater in patients requiring extended resection compared to standard resection (P=0.02, P=0.01, and P=0.02, respectively). Median follow-up for patients still alive was 84 months (range 40 to 189 months). Median survival following resection was 15.9 months compared to 5.8 months in patients who were not resected (P<0.0001). Actual 5- and 10-year survival rates were 22% and 18%, respectively, following extended resection, 8% and 8% following standard resection, and 0% and 0% if no resection was attempted because of locally unresectable disease. Patients undergoing extended resection for adenocarcinoma of the pancreatic body or tail have long-term survival rates similar to those for patients undergoing standard resection; they also have markedly improved long-term survival compared to those who are not considered resectable because of locally advanced disease. Extended distal pancreatectomy is justified in this group of patients. © 2003 The Society for Surgery of the Alimentary Tract. |
| Keywords: | adult; cancer survival; controlled study; treatment outcome; aged; aged, 80 and over; middle aged; survival analysis; survival rate; retrospective studies; major clinical study; splenectomy; conference paper; cancer patient; pancreas resection; pancreatic neoplasms; follow up; prospective study; adenocarcinoma; vascular surgical procedures; data base; length of stay; hospitalization; statistical significance; blood transfusion; long term care; pancreas adenocarcinoma; pancreatectomy; gastrectomy; neoplasm invasiveness; pancreatic adenocarcinoma; postoperative hemorrhage; portal vein; distal pancreatectomy; colectomy; adrenalectomy; pancreatic resection; humans; human; male; female |
| Journal Title: | Journal of Gastrointestinal Surgery |
| Volume: | 7 |
| Issue: | 8 |
| ISSN: | 1091-255X |
| Publisher: | Springer |
| Date Published: | 2003-12-01 |
| Start Page: | 946 |
| End Page: | 952 |
| Language: | English |
| DOI: | 10.1016/j.gassur.2003.08.004 |
| PUBMED: | 14675703 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Presented at the 44th Annual Meeting of The Society for Surgery of the Alimentary Tract; 2003 May 17-22; Orlando, FL -- Export Date: 25 September 2014 -- Source: Scopus |
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