| Background Most patients are in locally advanced stage when they are diagnosed aspancreatic cancer, with intractable pain and poor quality of life. Decision making forresection is difficult in cases of vessels invasion. Hence, our present study aims tocompare the feasibility and efficacy of resection and palliative treatments in patientswith vessels invaded pancreatic cancers.Method197patients divided into two groups according to tumor stage (by CT scan).Among them, patients with superior mesenteric vein/portal vein invasion wererandomized into resection group (IR) or palliative group (IP), where as those witharterial invasion or venous involvement but not technically resectable–palliativegroup (IIP)(three groups in all). In resection group, superior mesenteric vein/portalvein resection was performed. Palliative group received intratumoral implantation of125I seeds, celiac neurolysis with ethanol and procedures to relieve gastro duodenaland biliary obstruction.Results Palliative group provided good short term (84.6%) and long-term pain relief(89.2%) with fewer complications. Palliation provided a tumor response rate of75.9-78.9%. Three months after surgery, the palliative group had a better state of health.The median survivals for IR, IP and IIP groups were13,12and9months respectively.The1-,2-,3-, and5-year survival for the IR and IP groups were56,23,18, and9%and53,22,10and0%.Conclusion For patients with vein invaded pancreatic cancer, resection and palliationhave almost the same effects on quality of life and survival time but palliation wasassociated with fewer complications. However, vein resection was associated withbetter5-year survival. Palliation provided good results in pain relief and quality of lifein arterial invaded tumors. |
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