BACKGROUND/AIMS: Even with the recent advances of diagnostic and therapeutic modalities, the clinical course of @entity1 with @entity788 remains dismal. Five-year survivors are rare, cure is exceptional, and the operative mortality rate is significant. In this study, univariate and multivariate retrospective analyses were performed with regard to the prognostic parameters to clarify the problems in order to improve survival rates after surgical resection. METHODOLOGY: Clinical courses of 60 Japanese @entity1 with @entity788 who underwent surgical resection in one Japanese University Hospital were reviewed to scrutinize the influence of 22 prognostic (9 host-side, 5 operative and 8 @entity5 -side) factors. A special reference was made on intra-operative radiation therapy, portal vein resection, lymph node dissection around the aorta, and conventional pancreatoduodenectomy versus pylorus-preserving pancreatoduodenectomy in @entity788 . RESULTS: Univariate analysis showed that operation time, comprehensive stage, comprehensive curability, histopathologic grade of differentiation and histopathologic venous invasion were statistically significant factors. Multivariate Cox regression analysis regarding the 5 profound factors showed that histopathologic grade of differentiation and histopathologic venous invasion were independently significant factors. The 1- and 3-year survival rates of 18 @entity1 with intra-operative radiation therapy were 56% and 39%, while those of 36 @entity1 without intra-operative radiation therapy were 54% and 18%. The 1- and 3-year survival rates of 43 @entity1 with PV0,1 were 58% and 28%, while those of 17 with PV2,3 were 50% and 10%. Three @entity1 with PV2 in 1 and PV3 in 2 underwent a portal vein resection. Two of the 3 @entity1 were dead from liver @entity3 3 and 5 months after a surgical resection of liver @entity3 . The 1- and 3-year survival rates of 17 with radical lymph node dissection including the para-aortic area were 61% and 26%, while those of 27 without para-aortic lymph node dissection were 66% and 25%. Of the 17 @entity1 , the para-aortic lymph node was metastasized in 1 @entity1 . The 1- and 3-year survival rates of 31 with pancreatoduodenectomy were 53% and 18%, while the 1- and 3-year survival rates with pylorus preserving pancreatoduodenectomy were 68% and 28%, respectively. CONCLUSIONS: These findings suggest that the clinical outcome after surgical resection of @entity3123 depends on @entity5 -side factors not operative parameters or host-side parameters. The clinical course seems to rely upon the nature of @entity788 not upon the operative procedure.

XXXX : reappraisal of surgical experiences in one Japanese university hospital.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity3123 :: ('MESH:C562463', 'Disease') :: ['pancreatic carcinoma'] @entity788 :: ('MESH:D010190', 'Disease') :: ['pancreatic cancer', 'pancreatic head cancer'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis']
@entity3123 :: (MESH:C562463,Disease) :: ['Pancreatic carcinoma']
