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Background
Recent reports suggest an improved survival following resection for patients with
pancreatic carcinoma. However, the prognosis for patients with lymph nodes metastases
remains uncertain. The purpose of this study was to determine if the presence of lymph
node metastases significantly alters survival in patients with otherwise potentially
curable pancreatic carcinoma.
Patients and Methods
Between 1970 and 1995, 401 patients with pancreatic adenocarcinoma, including 327
patients with pancreatic head tumors, were evaluated and treated.
Results
One hundred (31%) patients underwent pancreatoduodenectomy. Operative mortality was
3% and morbidity was 22%. Median survival for 97 patients discharged from the hospital
following resection was 14 months (range 2 to 293). The estimated 1-, 2-, and 5-year
survivals were 61%, 43%, and 20%, respectively. Median survival was 11.5 months (range
2 to 87) for patients with positive lymph nodes (n = 56) and 24 (range 0 to 293) months
for patients with negative lymph nodes (n = 41; P = 0.0003). Ten patients (10%) survived longer than 5 years, and 9 (90%) of them had
negative lymph nodes. Elderly patients (≥70 years) had a median survival twice as
long as younger patients (24 versus 12 months, P = 0.03).
Conclusions
Lymph node metastases are found in 56% of patients undergoing resection. Pancreatoduodenectomy
can be performed with low operative mortality in patients of all ages. It offers good
palliation for patients with lymph nodes metastases and encouraging long-term survival
rates as well as a chance for cure in patients with negative lymph nodes.
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Article info
Footnotes
**Presented at the 48th Annual Meeting of the Southwestern Surgical Congress, Scottsdale, Arizona, April 28–May 1, 1996.
Identification
Copyright
© 1996 Excerpta Medica, Inc. All rights reserved. Published by Elsevier Inc.
