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Impact of Lymph Node Involvement on Long-term Survival after R0 Pancreaticoduodenectomy for Ductal Adenocarcinoma of the Pancreas

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Pancreaticoduodenectomy remains the only potentially curative treatment for adenocarcinoma of the pancreas. The aim of this study was to analyze prognostic factors impacting survival after R0 pancreaticoduodenectomy for adenocarcinoma in the head of the pancreas. Between 1995 and 2002, a potentially curative (R0) pancreaticoduodenectomy with pancreatogastrostomy for ductal adenocarcinoma in the head of the pancreas was performed in 81 patients (42 women and 39 men) with a mean age of 64 years (range 35–84). Patients were identified from a prospective database and records were reviewed retrospectively. Postoperative mortality was 1%, and 40% of patients had complications. Median survival was 18 months, and the 5-year survival was 24%. Fifteen patients were alive at 5 years. Factors associated with poor survival in multivariate analysis were (1) two or more positive lymph nodes, (2) tumor diameter greater than 30 mm, and (3) age greater than 70 years. In patients with no or with one positive lymph node, the 5-year survival was 44%. On the other hand, in patients with two or more positive lymph nodes, both the 3- and 5-year survival was 5%. The main risk factor associated with poor survival after an R0 pancreaticoduodenectomy for adenocarcinoma in the head of pancreas was lymph node status: The presence of two or more positive lymph nodes was associated with decreased survival.

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Authors and Affiliations

  1. Centre de Chirurgie Viscérale et de Transplantation Hôpital de Hautepierre, Hopitaux Universitaires de Strasbourg, Université Louis Pasteur, Avenue Molière, 67098, Strasbourg Cedex, France

    Thomas Zacharias, Daniel Jaeck, Elie Oussoultzoglou & Philippe Bachellier

  2. Service de Pathologie, Hôpital de Hautepierre, Hopitaux Universitaires de Strasbourg, Université Louis Pasteur, Avenue Molière, 67098, Strasbourg Cedex, France

    Agnes Neuville

Authors
  1. Thomas Zacharias
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  2. Daniel Jaeck
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  3. Elie Oussoultzoglou
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  4. Agnes Neuville
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  5. Philippe Bachellier
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Correspondence to Daniel Jaeck.

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Zacharias, T., Jaeck, D., Oussoultzoglou, E. et al. Impact of Lymph Node Involvement on Long-term Survival after R0 Pancreaticoduodenectomy for Ductal Adenocarcinoma of the Pancreas. J Gastrointest Surg 11, 350–356 (2007). https://doi.org/10.1007/s11605-007-0113-3

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  • DOI: https://doi.org/10.1007/s11605-007-0113-3

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