Radical pancreatic resection for benign and malignant disease

From 1972 to 1990 a total of 44 patients (24 men and 20 women) underwent pancreatic resections at our institution. We undertook a retrospective review to discover what prognostic indicators would predict long-term survival for patients with malignancy. Prognostic indicators included primary tumor location and size, tumor differentiation and grade, tumor invasion, number of positive lymph nodes, and postoperative radiation and chemotherapy. Overall, three patients died within the 30-day postoperative period (7%). One- and five-year survival rates following resection for malignancy were 67.5 and 31 per cent, respectively. Multivariate analysis identified primary tumor origin, nuclear grade, and preoperative bilirubin level greater than 2 mg/dl as the only statistically significant factors in determining survival. One- and five-year survival for tumor location and tumor grade were as follows: [table: see text] Our experience indicates that pancreatic resections are potentially curative in a significant percentage of patients with nonpancreatic primaries and, to a lesser extent, in those individuals with pancreatic adenocarcinoma. Other prognostic indicators examined in our series, however, did not affect long-term survival.