Pre-operative predictors of short-term survival after pancreatic cancer resection

The aim of the present study is to investigate the pre-operative factors that affect short-term survival after pancreatic cancer resection and to evaluate their prognostic value.

Fifty-nine patients with ductal adenocarcinoma of the pancreas operated on in the Second Department of Surgery, Hokkaido University Hospital between 1989 and 1996 were reviewed.

The patients had a mean age of 62.6 years. The difference of survival between patients aged 62 years or younger and older patients was significant (p=0.0053). Primary tumor size was evaluated with enhanced CT examination; 36 patients had tumors larger than 3 cm in diameter. The 1-year survival rate of patients with tumors 3 cm or less in diameter was significantly better than that of patients with primary tumors greater than 3 cm in diameter (p=0.0258). Analysis of carcinoembryonic antigen (CEA) showed a significant difference in 1-year survival rates between patients with a pre-operative value below twice the diagnostic cutoff level (cutoff index; C.I.) and patients with a value above this level (p=0.0006). The 1-year survival rate for the subset of younger patients (= or < 62 years) with smaller tumors (3 cm or less) and a lower pre-operative serum CEA level (= or < two times of C.I.), was 72.7% (n=11). Multivariate analysis indicated that age and the pre-operative serum CEA level were both independent prognostic factors of 1-year survival (p=0.0077, and 0.003, respectively), although the statistical significance of tumor size was weak (p=0.107).

It was suggested that age and serum CEA level were independent prognostic factors of short-term survival after pancreatic cancer resection.