Surgery Today

, Volume 29, Issue 1, pp 16–22

The prognostic significance of lymph node metastasis and intrapancreatic perineural invasion in pancreatic cancer after curative resection


  • Hideo Ozaki
    • Department of SurgeryNational Cancer Center Hospital
  • Takehisa Hiraoka
    • First Department of SurgeryKumamoto University School of medicine
  • Ryuji Mizumoto
    • First Department of SurgeryMie University Faculty of Medicine
  • Seiki Matsuno
    • First Department of SurgeryTohoku University School of Medicine
  • Yoshiro Matsumoto
    • First Department of SurgeryYamanashi Medical University
  • Toshimichi Nakayama
    • Second Department of SurgeryKurume University School of Medicine
  • Tsukasa Tsunoda
    • Second Department of SurgeryNagasaki University School of Medicine
  • Takashi Suzuki
    • Second Department of SurgeryYamaguchi University School of Medicine
  • Morito Monden
    • Second Department of SurgeryOsaka University Medical School
  • Yoichi Saitoh
    • First Department of SurgeryKobe University School of Medicine
  • Hidemi Yamauchi
    • Department of SurgerySendai National Hospital
  • Yoshiro Ogata
    • Department of SurgeryTochigi Cancer Center
Original Articles

DOI: 10.1007/BF02482964

Cite this article as:
Ozaki, H., Hiraoka, T., Mizumoto, R. et al. Surg Today (1999) 29: 16. doi:10.1007/BF02482964


To investigate the prognostic factors of pancreatic cancer, a retrospective analysis of 193 patients who underwent curative resection was conducted. Of the 193 patients, 38 (20%) survived for more than 5 years, the 5-year survival rates for stages I, II, III, and IV disease being 41%, 17% 11%, and 6%, respectively. According to a multivariate analysis, lymph node metastasis, intrapancreatic perineural invasion, and portal vein invasion were significant prognostic factors. Subsequently, a subgroup analysis concerning nodal metastasis and intrapancreatic perineural invasion was performed in 126 patients with records of these histological findings. In the group of patients without nodal metastasis, the 5-year survival rate for those without perineural invasion was 75%, whereas that for those with perineural invasion was 29%, the difference in survival of these subgroups being significant (P<0.02). In the group of patients with nodal metastasis, the 5-year survival rate for those without perineural invasion was 17%, while that for those with perineural invasion was 10%. The most favorable 5-year survival of 89% was observed in the subgroup of patients with stage I disease without perineural invasion. Thus, pancreatic adenocarcinoma categorized by the combination of these independent types of biological behavior showed 5-year survival rates ranging from very high to low, indicating that these two factors play an important role in the prognosis of this disease.

Key Words

pancreatic adenocarcinomapancreatectomyprognostic factorlymph node metastasisperineural invasion
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Copyright information

© Springer-Verlag 1999