Analysis of resectability and survival in pancreatic cancer patients with vascular invasion / 대한내과학회지

ABSTRACT

BACKGROUND: One of the major limitations of curative resection in pancreatic cancer patients is local tumor extension to the mesenteric vessels. Thus, the purposes of our study were (1) to assess the clinical value of contrast enhanced spiral CT in predicting the resectability and survival of pancreatic cancer patients with suspicious vascular invasion and (2) to assess the influence of curative resection on survival in these patients. METHODS: Forty cases of the pancreatic cancer patients who were suspected of having involvement of adjacent large vessels and subsequently underwent operation with curative intent were enrolled in this study. Resectability and survival were correlated with CT findings such as segment length, degree of encasement, type and number of vessel involved. Survival rate was compared between curative and palliative resection groups. And survival was also compared between resected and non-resected groups. RESULTS: Of the 40 patients with adenocarcinoma of the pancreas, 14 patients had curative resections, and 26 patients had palliative resections. The probability of curative resection was higher in patients with segment length less than 2 cm, compared with those with more than 2 cm. However, there was no difference in survival between two groups. There were no differences of resectability and survival according to the degree of encasement, type and number of vessel involved. There were no difference in survival between curative and palliative resection groups, and between resected and non-resected groups. CONCLUSION: A survival benefit is not achieved by curative resection in pancreatic cancer patients with vascular invasion. So other non-operative treatments should be considered as effective tools prior to resection in these patients.