Clinicopathological evaluation of long-term survivors treated for cancer of the head of pancreas.

BACKGROUND/AIMS: This is a study of 43 patients with cancer of the pancreatic head treated by resection in the past 13 years; 8 patients survived for 3 years or more and were compared with 17 who died of cancer within 3 years, in terms of histopathological spread.

METHODOLOGY

Eight patients with cancer of the pancreatic head who survived for 3 years or more after resection were evaluated clinically. They were compared histologically with 17 patients who died of cancer within 3 years.

RESULTS

The long-term survivors had s0 lesion (no frontal invasion of the pancreatic capsule). Lymph node metastasis was absent, or if present, limited to the n1 group. Histological examination showed rpe (positive retroperitoneal invasion) in four of the eight patients (50%). E-ew (-) (no evidence of invasion to the exposed cut surface) was obtained in all patients. They had stage (histological cancer Stage) II or III except for one patient with stage IV.

CONCLUSIONS

Based on the results of the evaluation of our patients, the preconditions at present for prolonged survival for patients with cancer of the pancreatic head would appear to be as follows: --no frontal invasion of the pancreatic capsule; --no retropancreatic invasion or no evidence of invasion to the exposed cut surface even if the retroperitoneal tissues are invaded; --no lymph node metastasis or metastasis limited to the first lymph node group.