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Debate: extended resection for pancreatic cancer; the affirmative case
1Second Department of Surgery, Nagoya Unversity Hospital, Nagoya, Japan.
Background/Purpose:
A clinical study was carried out to clarify the indications for extended resection of pancreatic cancer.
Methods:
From July 1981 to April 2000, 200 of 314 (63.7%) patients with pancreatic cancer underwent extended tumor resection. Portal vein resection was performed in 146 of the 200 (73%) resected cases. The postoperative survival rate was studied based on the operative and histopathological findings.
Results:
Operative death (within 30 days postoperatively) occurred in 11 of the 200 (5.5%) resected patients. Most of the patients who survived for 2 or 3 years were in the group with carcinoma-free surgical margins.
Conclusion:
The most important indication for an extended operation combined with portal vein resection for pancreatic cancer is the likelihood of obtaining surgical cancer-free margins. There is no indication for an extended resection inpatients in whom the surgical margins will become cancer-positive if such a resection is employed.