Evaluation of the Extended Radical Operation for Pancreatic Cancer.

Nakasako, Toshiaki; Hanyu, Fujio; Imaizumi, Tsutomu; Suzuki, Mamoru; Harada, Nobuhiko; Hatori, Takashi; Arai, Toshio; Hirose, Tetsuya; Fukuda, Akira; Munakata, Shigeru

doi:10.5833/jjgs.26.1147

Cited by 8 publications

(16 citation statements)

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“…Several studies have retrospectively examined margin status [3,17,18]. We recently reported that the indication for the portal vein resection is to obtain cancer-free margin and there is no indication for the resection of the tumor if cancer-free margin cannot be obtained by portal vein resection [3]. Trede et al [19] reported significantly reduced survival rate in patients with margin-positive resection.…”

Section: Discussionmentioning

confidence: 99%

“…The present study revealed that the PL status is significantly associated with the margin status which might be responsible for the dismal prognosis of those cases. Several studies have retrospectively examined margin status [3,17,18]. We recently reported that the indication for the portal vein resection is to obtain cancer-free margin and there is no indication for the resection of the tumor if cancer-free margin cannot be obtained by portal vein resection [3].…”

Section: Discussionmentioning

confidence: 99%

“…Operative resection provides the only chance for cure or long-term survival if the tumor is localized and resectable at the time of diagnosis. There are many factors such as advanced stage and positive resection margins shown to be responsible for the dismal survival of the patients with pancreatic carcinoma [2,3]. The extrapancreatic nerve plexus (PL) invasion is a common feature of pancreatic cancer and affects the outcome of patients after surgical resection [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…IPEUS shows the IPDA, uncus and PLph-II. ment of the PL around superior mesenteric artery (SMA) makes it impossible to achieve a negative retroperitoneal margin of excision even with radical resections [3][4][5][6][7][8]. The diagnosis of PL invasion can still be difficult and there has been no method reported for the accurate diagnosis of the PL invasion except IPEUS by our institution [9,10].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Significance of Intraportal Endovascular Ultrasonography for the Diagnosis of Extrapancreatic Nerve Plexus Invasion by Pancreatic Carcinoma

et al. 2004

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Significance of Intraportal Endovascular Ultrasonography for the Diagnosis of Extrapancreatic Nerve Plexus Invasion by Pancreatic Carcinoma

et al. 2004

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“…D1 -procedure only provided simple lymphadenectomy limited to the region of the head of pancreas without resection of surrounding connective tissues, and dissection of the second and tertiary group lymph node was inadequate for the purpose of lymphatic clearance. Theoretically D2 + procedure could achieve a microscopic curative resection [15,16] . Macroscopic curative resection has been proven to be microscopic noncurative resection by precise serial section analysis.…”

Section: Discussionmentioning

confidence: 99%

Risk factors influencing recurrence following resection of pancreatic head cancer

Mu¹,

Peng²,

Wang³

2004

WJG

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AIM:Whether operative procedure is a risk factor influencing recurrence following resection of carcinoma in the head of pancreas or not remains controversies. In this text we compared the recurrence rate of two operative procedure: the Whipple procedure and extended radical operation, and inquired into the factors influencing recurrence after radical resection. METHODS:From January 1995 to December 1998, 35 cases of carcinoma of pancreas underwent the Whipple operadure, 21 patients received the Extended radical operation. All patients were followed up for more than 3 years. Prognostic factors included operative procedure, size of tumor, lymph node, interstitial invasion. RESULTS:Deaths duo to recurrence within 3 years after operation were studied. The death rate was 51.4% in the Whipple procedure and 42.9% in the Extended radical operative procedure. There was a significant difference between the two groups. Recurrence occurred in 75% patients with tumor large than 4 cm, in 87.5% patients with lymph node involvement, and in 50% patients with the presence of interstitial invasion. CONCLUSION:Tumor exceeding 4 cm, lymph node involvement, and presence of interstitial invasion are high risk factors of recurrence after Whipple's procedure and extended radical operation.Mu DQ, Peng SY, Wang GF. Risk factors influencing recurrence following resection of pancreatic head cancer. World J Gastroenterol 2004; 10(6): 906-909

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Clinical analysis of TS1 carcinoma of the pancreas

Hatori

Imaizumi

Nakasako

et al. 1995

J Hep Bil Pancr Surg

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Abstract:In 40 patients with tumor size (TS)I pancreatic cancer with a TS of 2 cm or less, the tumor was classified as without direct extrapancreatic invasion in 11 patients (ha, group) and as with direct extrapancreatic invasion in 29 patients (t2t 3 group). Ultrasonography (US) and endoscopic retrograde cholangio-pancreatography (ERCP) were useful for the diagnosis, with accuracy rates of 80% and 75%, respectively, in the tla group and 78% and 75% in the t2t 3 group. The accuracy rate of preoperative integrated imaging diagnosis was 83% in the t2t3 group but only 55% in the tla group. All of the t2t 3 patients were stage III or higher and 18% of the ha patients had lymph node metastasis, indicating the need for extended radical operation in TS1 pancreatic cancer. Because standard operation is indicated when the preoperative diagnosis is not pancreatic cancer, accurate preoperative diagnosis is very important. The rate of curative resection and the 5-year survival rate were 100% and 56%, respectively, in the tla group and there were two 5-year survivors. The rate of non-curative resection and the 5-year survival rate were 31% and 35%, respectively, in the t2t 3 group and there were three 5-year survivors. In the light of these findings, it is therefore important to make an accurate diagnosis of ha pancreatic cancer of TS1 pancreatic cancer without direct extrapancreatic invasion. As liver metastasis was frequently observed in both the tla and t2t3 groups, the establishment of effective measures to inhibit liver metastasis is considered urgent to improve the result of TS1 pancreatic cancer surgery.Key words: TS1 (2 cm or less) pancreatic carcinoma, imaging diagnosis, extended radical operation with D2 lymph node dissection, liver metastasis Offprint requests to: T. Hatori

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Evaluation of the Extended Radical Operation for Pancreatic Cancer.

Cited by 8 publications

References 0 publications

Clinical Significance of Intraportal Endovascular Ultrasonography for the Diagnosis of Extrapancreatic Nerve Plexus Invasion by Pancreatic Carcinoma

Clinical Significance of Intraportal Endovascular Ultrasonography for the Diagnosis of Extrapancreatic Nerve Plexus Invasion by Pancreatic Carcinoma

Risk factors influencing recurrence following resection of pancreatic head cancer

Clinical analysis of TS1 carcinoma of the pancreas

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