[Factors influencing long-term prognosis after pancreatoduodenectomy in cancer of the pancreas head].

Sixty-four cases of pancreatoduodenectomy were performed for ductal adenocarcinoma of the head of pancreas. According to the size of primary tumor, the cases were divided into 3 groups: less than 2 cm, 2.1 to 4.0 cm, and more than 4 cm. The corresponding one-year survival was 66.7%, 33.7%, and 25.0% (P less than 0.05), respectively. The one-year survival of cases with tumor confined to pancreas or only involving intrapancreatic common bile duct or duodenal wall in the ampullary region (100%) was higher than that of cases with microscopic and macroscopic local infiltration (33.3%, 54.5%) and that of cases with large or middle extrapancreatic vessels involved (11.1%) (P less than 0.001). The rate of lymph node metastases of all cases was 69%. The one-year survival of cases with primary lymph node metastases was lower than that of cases without it (32.4% v. 62.5%, P less than 0.05). Based on the above mentioned result, a new staging method is suggested.