Management of Adenocarcinoma of the Body and Tail of the Pancreas

Abstract

The authors examined the resectability, operative morbidity mortality, and survival of patients with pancreatic adenocarcinoma of the body and tail compared with lesions in the head. Adenocarcinoma of the body and tail of the pancreas is characteristically thought of as a disease that presents late and rarely is operable or resectable. In an 11-year period, 1981 patients were admitted and entered into a prospective database at Memorial Sloan-Kettering Cancer Center with a diagnosis of peripancreatic cancer, 1363 of whom had adenocarcinoma of the pancreas, 75% with lesions in the head and 25% with lesions in the body and tail. Of 271 patients resected, 237 (23%) had lesions in the head and 34 (10%) had body and tail lesions. Perioperative mortality was 4% for patients with pancreatic lesions in the head and 0% for patients with pancreatic lesions in the body and tail. Five-year actuarial survival for body and tail lesions was projected at 14% for 5 years. Actual survival was 19%, with three patients alive for more than 5 years. Adenocarcinoma of the body and tail of the pancreas, although less likely to be resectable at presentation than lesions in the pancreatic head, have similar postresection survival.