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

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Abstract

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.

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Authors and Affiliations

  1. Department of Surgery, National Cancer Center Hospital, 1-1 Tsukiji 5-Chome, Chuo-ku, 104, Tokyo, Japan

    Hideo Ozaki

  2. First Department of Surgery, Kumamoto University School of medicine, 1-1-1 Honjo, 860, Kumamoto, Japan

    Takehisa Hiraoka

  3. First Department of Surgery, Mie University Faculty of Medicine, 2-174 Edobashi, 514, Tsu, Japan

    Ryuji Mizumoto

  4. First Department of Surgery, Tohoku University School of Medicine, 1-1 Seiryo-cho, Aoba-ku, 980, Sendai, Japan

    Seiki Matsuno

  5. First Department of Surgery, Yamanashi Medical University, 1110 Tamaho, 409-38, Yamanashi, Japan

    Yoshiro Matsumoto

  6. Second Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, 830, Kurume, Japan

    Toshimichi Nakayama

  7. Second Department of Surgery, Nagasaki University School of Medicine, 7-1 Sakamoto-machi, 852, Nagasaki, Japan

    Tsukasa Tsunoda

  8. Second Department of Surgery, Yamaguchi University School of Medicine, 1144 Kogushi, Nishi-ku, 755, Ube, Japan

    Takashi Suzuki

  9. Second Department of Surgery, Osaka University Medical School, 2-2 Yamadaoka, 565, Suita, Japan

    Morito Monden

  10. First Department of Surgery, Kobe University School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, 650, Kobe, Japan

    Yoichi Saitoh

  11. Department of Surgery, Sendai National Hospital, 2-8-8 Miyagino, Miyagino-ku, 983, Sendai, Japan

    Hidemi Yamauchi

  12. Department of Surgery, Tochigi Cancer Center, 4-9-13 Yonan, 320, Utsunomiya, Japan

    Yoshiro Ogata

Authors
  1. Hideo Ozaki
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  2. Takehisa Hiraoka
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  3. Ryuji Mizumoto
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  4. Seiki Matsuno
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  5. Yoshiro Matsumoto
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  6. Toshimichi Nakayama
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  7. Tsukasa Tsunoda
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  8. Takashi Suzuki
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  9. Morito Monden
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  10. Yoichi Saitoh
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  11. Hidemi Yamauchi
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  12. Yoshiro Ogata
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Ozaki, H., Hiraoka, T., Mizumoto, R. et al. The prognostic significance of lymph node metastasis and intrapancreatic perineural invasion in pancreatic cancer after curative resection. Surg Today 29, 16–22 (1999). https://doi.org/10.1007/BF02482964

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  • DOI: https://doi.org/10.1007/BF02482964

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