Abstract
Background: Pancreatic ductal adenocarcinoma (PDAC) continues to have the poorest prognosis of all gastrointestinal malignancies, even after the tumor has been completely resected. The factors predictive of achieving 5-year survival remain unclear. Aim: The aim of this study was to investigate the pre-and postoperative clinicopathological characteristics of PDAC patients with a >5-year survival after curative resection. Materials and Methods: We retrospectively reviewed patients who underwent pancreatectomy for PDAC between January 1995 and December 2011. Logistic regression analysis was performed to determine the predictive factors for 5-year survival. Results: One hundred and fifty-one patients were enrolled in this study. According to the UICC TNM classification, Stage IA/IB/IIA/IIB/III/IV were 6/7/36/89/1/12, respectively. Twenty-three patients received neoadjuvant chemoradiotherapy (NACRT) and 79 patients received perioperative portal vein infusion chemotherapy (PVICT). Of the 151 patients, 38 were survived more than 5-year and actual 5-year survival rate was 25.2%. Sixteen patients in the <5-year survival group survived without recurrence and seven patients survived with recurrence. Eleven patients died of PDAC and four patients died of other causes. The independent preoperative factors predictive of achieving 5-year survival included serum albumin levels (odds ratio [OR]: 5.06, 95.0% confidence interval [CI]: 1.49–17.19; P = 0.009) and NACRT (OR: 3.02, 95.0% CI: 1.00–9.08; P = 0.049). Venous infiltration (OR: 2.99, 95.0% CI: 1.09–8.25; P = 0.034), liver recurrence (OR: 0.17, 95.0% CI: 0.04–0.69; P = 0.013), and perioperative PVICT (OR: 3.06, 95.0% CI: 1.09–8.25; P = 0.028) were found to be independent postoperative predictive factors for achieving 5-year survival. Patients receiving NACRT did not have a significantly longer DFS. However, they did have a significantly longer OS (P = 0.045). Conclusions: NACRT and perioperative PVICT were identified as significant predictive factors, suggesting that multidisciplinary treatment could be promising for improving the survival rate of PDAC patients.
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