BACKGROUND: Since 1995, we have been performing pancreatoduodenectomy with regional and para-aortic lymph node dissection for @entity1 with @entity1126 . Prognostic indicators after extended lymphadenectomy have not been fully understood. HYPOTHESIS: Pancreatoduodenectomy with extended lymphadenectomy and adjuvant chemotherapy is the treatment of choice for @entity1 with @entity1126 . DESIGN: In a retrospective study, univariate and multivariate models were used to analyze the effect of @entity1 demographics, @entity5 characteristics, and treatment factors on long-term survival. SETTING: Oita Medical University and its affiliated hospitals in Japan. @entity1 : From 1995 to 1999, 27 @entity1 with @entity1126 underwent pancreatoduodenectomy with extended lymphadenectomy. In 9 @entity1 @entity1487 (500 mg/d) was infused continuously for 14 days after surgery as adjuvant chemotherapy. MAIN OUTCOME MEASURES: Clinicopathologic characteristics and long-term results. RESULTS: In 6 @entity1 (22%) major surgical complications occurred including 1 in-hospital death (3.7%). For 26 @entity1 , the survival rates were 65% for 1 year and 37% for 3 and 5 years. Univariate analysis found that the absence of lymph node @entity3 , no more than 2 involved nodes, and negative resection margins were predictors of survival. Multivariate analysis with a Cox proportional hazards regression model revealed that favorable factors for survival included up to 2 positive nodes, negative resection margins, and the use of postoperative adjuvant chemotherapy. CONCLUSIONS: @entity1 with up to 2 positive lymph nodes had a more favorable prognosis than that of other @entity1 . We recommend pancreatoduodenectomy with extended lymphadenectomy and adjuvant chemotherapy for the treatment of @entity1 with @entity1126 .

Prognostic factors after pancreatoduodenectomy with extended lymphadenectomy for XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'PATIENTS'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity1126 :: ('MESH:D001650', 'Disease') :: ['distal bile duct cancer'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis'] @entity1487 :: ('MESH:D005472', 'Chemical') :: ['fluorouracil']
@entity1126 :: (MESH:D001650,Disease) :: ['distal bile duct cancer']
