Surgical potentialities for the treatment of pancreatic cancer

The incidence of pancreatic cancer is rising in all developed countries. The aim of this study is to define the surgical options in the treatment protocols for this disease and to evaluate the effect of radical resections.

One hundred ninety six consecutive patients with pancreatic cancer, operated in our department in a 4-year period, were evaluated. Among them, 106 were radically operated and the rest underwent palliative procedures.

Twenty-eight of the presented patients underwent pancreatic resection with simultaneous vessle resection, venous in 26 cases and arterial in 2 cases. Seventeen extended resections were made. The rate of postoperative morbidity of the radically operated was 36.8% (39 patients). Early bleeding (10 cases) and pancreatic fistula (10 cases) were the most common major complications. The 3-year survival rate of the radically operated patients was 21.5% vs. 0% in these with palliative procedures. The data analysis revealed no statistically significant difference in the survival of patients with modifications of pancreaticoduodenectomy, Whipple and PPPD (p=0.065).

The radical surgery ensures better long-term results. We recommend this type of surgery to be concentrated in highly specialized centers in order to improve the outcome.