Objective: To evaluate retrospectively the relationship between the types of operation, characteristics of tumor, and survival rate after radical pancreatoduodenectomy for patients with carcinoma of the pancreatic head performed in recent 30 years.
Methods: Of 377 patients with carcinoma of the pancreas treated during 1970-1999, 75 were subjected to Whipple procedure or pancreatectomy with dissection of regional lymph nodes (10 patients receiving intervention therapy). The latter is beneficial to patients with carcinoma of the pancreatic head. The operation may be extended by resection of a segment of superior mensenteric-portal vein confluence if involved.
Results: The resection rate was increased from 9% in the 1970s to 28.2% in the 1990s. The 1-, 3-, 5-year-survival rates were 50%, 25%, 0 in the 1970s; 57.1%, 28.5%, 9% in the 1980s; and 61.1%, 27%, 11.1% in the 1990s, respectively.
Conclusion: Despite its retrospective in nature, the present study suggests that in patients with pancreatic cancer without visceral or distant metastasis, resection should always be at tempted when there is no high operative risk factor and the operation is technically feasible.