Surgical Treatment Results And Prognostic Analysis Of 89 Cases With Pancreatic Cancer

Objective:In this article, we reported on experience in treating pancreatic cancer. The objective was to investigate the association of clinicopathological factors with resectability of pancreatic cancer. And also we investigated the prognostic factors of pancreatic cancer patients who underwent surgical treatment in Qilu Hospital of Shandong University between May 2003 and January 2008.METHODS:This study consisted of a retrospectively review of all cases with pancreatic cancer at a single hospital (Qilu hospital of Shandong university). We retrospectively analyzed the clinical data of 89 consecutive patients underwent surgical treatment at our hospital. All patients with pancreatic cancer treated by surgery between May 2003 and January 2008 were eligible for the study. Clinical data of 89 patients during hospital stay were analyzed, including age, gender, clinical symptoms, laboratory findings, results of imaging examinations, diabetes, jaundice, period of disease, methods of surgical treatment, length of hospital stay, and clinopathological data of tumor. Follow-up data was established by phone follow-up either directly to the patients or to families or referring physician. Questions were addressed in regard to all-cause death and the exact death time. We investigated the clinicopathological factors that could be associated with curative resection and overall survival after surgical treatment. The cumulative survival was determined by the Kaplan-Meier method, and univariate comparisons between the groups were performed using the log-rank test. Multivariate analysis was performed using the Cox proportional hazard model.RESULTS:The study patients comprised 57 men and 32 women aged 20-80 years. Disease duration ranged from 5 days to 1/2 year. Four patents (4/89) had postoperative morbidity. The follow-up rate was 49.4% in these patients. Univariate analyses identified the following statistically significant prognostic factor in pancreatic cancer patients who underwent potentially curative resection:diameter of the tumor (P<0.01), lymph node metastasis (P<0.05), and surgical procedure (P< 0.01). In multivariate analyses, only surgical procedure was identified as an independent prognostic factor for long-term survival.Conclusion:The patients at early stage of TSN, without venous invasion and/or distal metastasis had higher resection rate. In multivariate analyses, only surgical procedure was identified as an independent prognostic factor for pancreatic cancer patients who underwent surgical treatment.