J.Jpn. Surg. Soc.. 87(9): 1173-1176, 1986

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Report on the annual meeting

PROBLEMS IN EXTENDED RESECTION FOR CANCER OF THE HEAD OF THE PANCREAS

During the period between 1968 and 1985, 548 cases of pancreatic carcinoma were experienced and 130 cases with duct cell cancer of the head of the pancreas underwent pancreatectomy. Ninety one cases underwent extended operation, which resected both adjacent tissue and pancreas, including either en bloc removal of lymph nodes with retroperitoneal connective tissue or portal vein, hepatic artery and superior mesenteric vessels.
Overall operative mortality of this operation was 6.6% (6 among 91 cases). Survival cases were rare in non-curative resection because of death by local recurrence and/or distant matastases within a year, but 2 curative patients are fortunately still alive for more than 5 years.
There were only 10 cases of T1 (7.7% of 130, 1.8% of 548), and 10% were in stage I, 40% in stage II and 50% in stage III, suggesting small pancreatic cancer is not compatible with early cancer histopathologically.
In our studies, the optimum treatment for patients with cancer of the head of the pancreas is a curative subtotal extended pancreatectomy in T1-3, RpO-2, VO-2, NO-2, Stage I-III except T4, Rp3, V3, N3, Stage IV followed by intra- and post-operative irradiation with adjuvant chemotherapy effectively.

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