Radical resection and outcome for malignant tumors of the pancreatic body and tail

摘要

AIM:To analyze the factors influencing radical(R0) resection rate and surgical outcome for malignant tumor of the pancreatic body and tail.METHODS:The clinical and operative data and followup results of 214 pancreatic body and tail cancer patients were analyzed retrospectively.RESULTS:One hundred and twenty/214 pancreatic body and tail cancer patients underwent surgical treatment;the overall resection rate was 59.2%(71/120) ,and the R0 resection rate was 40.8%(49/120) .Compared with non-R0 treatment,the patients receiving an R0 resection had smaller size tumor(P < 0.01) ,cystadenocarcinoma(P < 0.01) ,less lymph node metastasis(P < 0.01) ,less peri-pancreatic organ involvement(P < 0.01) and earlier stage disease(P < 0.01) .The overall 1-,3-and 5-year survival rates for pancreatic body and tail cancer patients were 12.7%(25/197) ,7.6%(15/197) and 2.5%(5/197) ,respectively,and ductal adenocarcinoma patients had worse survival rates [15.0%(9/60) ,6.7%(4/60) and 1.7%(1/60) ,respectively] than cystadenocarcinoma patients [53.8%(21/39) ,28.2%(11/39) and 10.3%(4/39) ](P < 0.01) .Moreover,the 1-,3-and 5-year overall survival rates in patients with R0 resection were 55.3%(26/47) ,31.9%(15/47) and 10.6%(5/47) ,respectively,significantly better than those in patients with palliative resection [9.5%(2/21) ,0 and 0] and in patients with bypass or laparotomy [1.2%(1/81) ,0 and 0](P < 0.01) .CONCLUSION:Early diagnosis is crucial for increasing the radical resection rate,and radical resection plays an important role in improving survival for pancreatic body and tail cancer patients.