Background and objectives:
Recent reports have demonstrated improvement in the 5-year actuarial survival for patients with resected ductal adenocarcinoma. the purpose of this study is to determine the factors favoring long-term survival after pancreaticoduodenectomy.
Methods:
Between 1974 and 1995, 75 patients with pancreatic head carcinoma underwent pancreaticoduodenectomy in our department.
Results:
Overall postoperative mortality rate was 5. 3% and morbidity was 24%. median survival following resection was 17 months. estimated 1-, 2-, and 5-year survival rates were 68%, 46.7%, and 18.7%, respectively. five-year survival was greater for node-negative than for node-positive patients (41.7% vs. 7.8%, p < 0. 001) and for smaller (<3 cm) than for larger tumors (33.3% vs. 8.8%, p < 0.006). the 5-year survival in patients with negative margins (n = 60) was 23.3%, whereas no patient with positive margins (n = 15) survived at 13 months (p < 0.001). multivariate analysis, performed by the cox proportional hazards model, indicated that margin status, lymph node metastasis, tumor size, and poor histological differentiation were independent predictors of poor survival.
Conclusions:
Five-year survival for patients undergoing pancreaticoduodenectomy for ductal adenocarcinoma of the pancreas was 18.7%. survival was greater in the group of patients with negative lymph nodes, tumor size <3 cm, and negative margin status.