Long-term survival after pancreaticoduodenectomy for pancreatic and periampullary adenocarcinomas

Abstract

Background: Long-term survival for those with pancareatic cancer is not common. Aims: This study was to identify predictors for long-term survival and to compare survivals for periampullary adenocarcinomas after a pancreaticoduodenectomy. Patients & methods: Clinicopathological factors were compared between short-term ( 5 years) survival groups. Both actuarial and actual 5-year survival, as well as actuarial 10-year survival for those that survived over 5 years, were determined. Results: There were 109 (21.8%) long-term survivors. Most (76%) of the long-term survivors were those with ampullary adenocarcinoma. Long-term survival was highest for ampullary adenocarcinoma (32.8%) and lowest for pancreatic adenocarcinoma (6.5%). Jaundice, tumor size, and lymph node involvement were found to be independent predictors for long-term survival. Prognosis was significantly worse for pancreatic adenocarcinoma, which had an actuarial 5-year survival of only 6.7%. There was no difference in subsequent actuarial 5-year survival (actuarial 10-year survival) between pancreatic adenocarcinoma and other periampullary adenocarcinomas for patients surviving over 5 years after resection. However, there was a difference in actuarial and actual 5-year survivals. Conclusion: Jaundice, tumor size, and lymph node involvement are independent predictors for long-term survival after pancreaticoduodnectomy. The biological factors of pancreatic adenocarcinoma no longer play a role in determining the prognosis for those who survive to the 5 year landmark.