Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Feb 28, 2010; 16(8): 997-1002
Published online Feb 28, 2010. doi: 10.3748/wjg.v16.i8.997
Prognosis and feasibility of en-bloc vascular resection in stage II pancreatic adenocarcinoma
K Dilip Chakravarty, Jun-Te Hsu, Keng-Hao Liu, Chun-Nan Yeh, Ta-Sen Yeh, Tsann-Long Hwang, Yi-Yin Jan, Miin-Fu Chen
K Dilip Chakravarty, Jun-Te Hsu, Keng-Hao Liu, Chun-Nan Yeh, Ta-Sen Yeh, Tsann-Long Hwang, Yi-Yin Jan, Miin-Fu Chen, Department of General Surgery, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Kwei-Shan Shiang, Taoyuan 333, Taiwan, China
Author contributions: Hwang TL and Chakravarty KD contributed equally to this work; Chakravarty KD wrote the paper; Hsu JT, Liu KH, Yeh CN, Yeh TS, Hwang TL, Jan YY and Chen MF provided the cases and suggestions.
Correspondence to: Tsann-Long Hwang, MD, Department of General Surgery, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Kwei-Shan Shiang, Taoyuan 333, Taiwan, China. hwangtl@adm.cgmh.org.tw
Telephone: +886-3-3281200-3219 Fax: +886-3-3285818
Received: June 19, 2009
Revised: January 15, 2010
Accepted: January 22, 2010
Published online: February 28, 2010
Abstract

AIM: To establish the prognosis and feasibility of en-bloc vascular resection of stage II pancreatic adenocarcinoma of the head and uncinate process.

METHODS: We retrospectively analyzed 87 patients with stage II pancreatic adenocarcinoma, who were subjected to pancreaticoduodenectomy (PD) and pylorus-preserving PD (PPPD) between 1996 and 2006 in Chang Gung Memorial Hospital, Taiwan. Twelve and 75 patients underwent PD/PPPD with and without resection of portal vein/superior mesenteric vein (PV/SMV), respectively.

RESULTS: The overall 1- and 3-year survival rates of patients undergoing PD/PPPD with and without vascular resection were 50.0% and 16.7%, and 44.4% and 12.2%, respectively. Morbidity and mortality rates in the PV/SMV resection vs non-resection group were 50.0% and 0.0%, and 40.0% and 2.7%, respectively. In multivariate analysis, serum bilirubin, histological differentiation and adjuvant chemotherapy were independent prognostic factors that influenced survival.

CONCLUSION: In stage II adenocarcinoma of the pancreatic head and uncinate process, serum bilirubin, histological differentiation and adjuvant chemotherapy were independent prognostic factors, and en-bloc vascular resection is a feasible option in carefully selected patients.

Keywords: Pancreatic neoplasms; Adenocarcinoma; Portal vein; Superior mesenteric vein; Pancreaticoduodenectomy; Chemotherapy