[Abstract] [Full Text PDF] (in Japanese / 3155KB) [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 98(5): 505-510, 1997


Feature topic

EVALUATION OF TREATMENT FOR CARCINOMA OF THE PAPILLA OF VATER

The Second Department of Surgery, Kurume University School of Medicine, Kurume, Japan

Hisafumi Kinoshita, Toshimichi Nakayama, Shichi Fukuda, Hiroyasu Imayama

105 cases of resected carcinoma of the papilla of Vater were studied and 5-year cumulative survivaI rate of PD was 56.5% and that of each stage was as follows : stage I 93.3%, stage II 70.2%, stage III 7.3%, stage IV 0%. The most significant histological factor influencing on prognosis was pancreatic invasion. 3-year survival rate of panc 1a was 75.0%, significantly much better than that of panc 1b (29.8%). The lymph node metastasis was frequently noted at no. 14 (11.5%). All of no. 14 lymph-adenectomy and no. 16 lymph-adenectomy on the case suspected as pancreatic parenchymal invasion, produced long-term survive even with metastasis of no. 14. This method led improvement of prognosis of stage II and stage III determined by lymph node factor. However, each prognosis of panc 1b, 2, 3 cases was not improved by this method, especially panc 2, 3 cases survived fewer than only 2 years. Extended lymphadenectomy and multimodality therapy were needed on the cases which were suspected as pancreatic parenchymal invasion.


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