Debate: extended resection for pancreatic cancer; the affirmative case

Background/Purpose. A clinical study was carried out to clarify the indications for extended resection of pancreatic cancer. Methods. From July 1981 to April 2000, 200 of 314 (63.7%) patients with pancreatic cancer underwent extended tumor resection. Portal vein resection was performed in 146 of the 200 (73%) resected cases. The postoperative survival rate was studied based on the operative and histopathological findings. Results. Operative death (within 30 days postoperatively) occurred in 11 of the 200 (5.5%) resected patients. Most of the patients who survived for 2 or 3 years were in the group with carcinoma-free surgical margins. Conclusion. The most important indication for an extended operation combined with portal vein resection for pancreatic cancer is the likelihood of obtaining surgical cancer-free margins. There is no indication for an extended resection in patients in whom the surgical margins will become cancer-positive if such a resection is employed. Received: August 12, 2002 / Accepted: August 24, 2002 RID="*" ID="*" Offprint requests to: A. Nakao