Adenocarcinoma of the pancreas. A ten-year experience

The experience with proved pancreatic adenocarcinoma in Portland, Ore, for 1965 through 1975 is compared with the decade 1955 through 1965. Little difference is found in time of diagnosis, incidence of resection vs bypass or laparotomy, types of resection, and overall survival. However, operative mortality improved and survival after total pancreatectomy improved from seven to 23 months. Whipple resections leave residual pancreatic tumor in one third of patients. Combining fluorouracil and radiotherapy significantly increases survival after palliative bypass (15 months vs 7.4 months, P less than .02). Based on low operative mortality, improved survival, and avoidance or residual tumor, use of total pancreatectomy as the resection of choice is recommended.