Long-term survivors after operation on carcinoma of the pancreas.

Reports of 35 long-term more than five years survivors after resectional surgery which was performed for carcinoma of the pancreas from 1966 to 1980 were collected from major institutions in Japan and analyzed. Male to female ratio was 0.94:1 and average age was 56 years old. In 34 of the 35, the tumor was located at the head of the pancreas, 32 received pancreatoduodenectomy and two underwent total pancreatectomy. One patient with carcinoma of the tail received distal pancreatectomy. There was no correlation between the size of tumor and the postoperative prognosis. It seems that lymph node metastasis is not an obstacle to long postoperative survivals when they are removed, and also invasion to the pancreatic capsule shows no relationship to prognosis. However, there were no definite or severe invasions to the retroperitoneal tissue, nor to the portal venous system in the 35 patients at all. It is considered that invasion to the retroperitoneal tissues and to the portal venous system may be the most influential factor to the postoperative prognosis.