Chakravarty KD, Hsu JT, Liu KH, Yeh CN, Yeh TS, Hwang TL, Jan YY, Chen MF. Prognosis and feasibility of en-bloc vascular resection in stage II pancreatic adenocarcinoma. World J Gastroenterol 2010; 16(8): 997-1002 [PMID: 20180240 DOI: 10.3748/wjg.v16.i8.997]
Corresponding Author of This Article
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
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World J Gastroenterol. Feb 28, 2010; 16(8): 997-1002 Published online Feb 28, 2010. doi: 10.3748/wjg.v16.i8.997
Table 1 Clinicopathological features of patients with stage II pancreatic adenocarcinoma (mean ± SD) n (%)
Parameters
With vascular resection (n = 12)
Without vascular resection (n = 75)
P value
Age (yr)
62.9 ± 11.0
62.9 ± 9.8
0.994
Gender
0.745
Male
7 (58.3)
50 (66.7)
Female
5 (41.7)
25 (33.3)
Symptoms
Jaundice
6 (50.0)
55 (73.3)
0.171
Abdominal pain
6 (50.0)
35 (46.7)
0.830
Body weight loss
6 (50.0)
31 (41.3)
0.573
Anorexia
3 (25.0)
17 (22.7)
1.000
Signs
Anemic
4 (33.3)
38 (50.7)
0.265
Icterus
6 (50.0)
54 (72.0)
0.178
Abdominal tenderness
3 (25.0)
15 (20.0)
0.707
Albumin (g/dL)
3.9 ± 0.6
3.7 ± 0.5
0.205
Total bilirubin (mg/dL)
6.8 ± 7.0
8.9 ± 7.1
0.333
Pre-op biliary drainage
0.573
Yes
6 (50.0)
44 (58.7)
No
6 (50.0)
31 (41.3)
CEA (ng/mL)
1.000
≤ 5
5 (62.5)
36 (62.1)
> 5
3 (37.5)
22 (37.9)
CA19-9 (U/mL)
0.411
≤ 37
3 (33.3)
13 (21.0)
> 37
6 (66.7)
49 (79.0)
Operation time (min)
473.9 ± 185.2
461.6 ± 110.4
0.826
Blood transfusion (mL)
396 ± 588
304 ± 590
0.618
Tumor size (cm)
3.6 ± 1.6
3.3 ± 1.4
0.526
Lymph node metastases
0.097
Yes
8 (66.7)
65 (86.7)
No
4 (33.3)
10 (13.3)
Curability
0.015
Yes
12 (100.0)
48 (64.0)
No
0 (0.0)
27 (36.0)
Postoperative chemotherapy
0.436
Yes
8 (66.7)
41 (54.7)
No
4 (33.3)
34 (45.3)
Table 2 Morbidity and mortality in patients with stage II pancreatic adenocarcinoma n (%)
Parameters
With vascular resection (n = 12)
Without vascular resection (n = 75)
Morbidity
6/12 (50.0)
30/75 (40.0)
Pancreatic leakage
2 (16.7)
9 (12.0)
Pancreatic fistula
0 (0.0)
8 (10.7)
Gastrointestinal bleeding
1 (8.3)
6 (8.0)
Pleural effusion
2 (8.3)
4 (5.3)
Delayed gastric emptying
1 (8.3)
3 (4.0)
Wound infection
0 (0.0)
4 (4.0)
Intra-abdominal abscess
0 (0.0)
4 (5.3)
Bile leakage
1 (8.3)
3 (4.0)
Sepsis
0 (0.0)
3 (4.0)
Intra-abdominal bleeding
1 (8.3)
2 (2.7)
Mortality
0 (0.0)
2 (2.7)
Table 3 Univariate analyses of predictive factors for survival of patients with stage II adenocarcinoma of the pancreas after PD or PPPD, with or without vascular resection
Table 4 Multivariate analysis in stage II pancreatic adenocarcinoma of the head and uncinate process
Parameters
Hazard ratio (95% CI)
P value
Bilirubin (mg/dL)
≤ 2/> 2
2.024 (1.613-3.774)
0.026
Differentiation
0.005
Moderately/well
2.412 (1.379-4.217)
0.002
Poorly/well
2.091 (1.034-4.225)
0.040
Adjuvant chemotherapy
No/yes
2.068 (1.270-3.366)
0.003
PV/SMV resection
Yes/no
0.591
Citation: Chakravarty KD, Hsu JT, Liu KH, Yeh CN, Yeh TS, Hwang TL, Jan YY, Chen MF. Prognosis and feasibility of en-bloc vascular resection in stage II pancreatic adenocarcinoma. World J Gastroenterol 2010; 16(8): 997-1002