Original CommunicationIs celiac axis resection justified for T4 pancreatic body cancer?
Section snippets
Patients and methods
Between January 1991 and April 2009, 71 patients underwent DP with or without resection of CA for pancreatic body cancer involving major vessels, the extrapancreatic neural plexus, or other organs, which was classified as T4 cancer according to the 5th edition of the General Rules for the Study of Pancreatic Cancer issued by the Japan Pancreas Society (JPS 5th edition).19 Pancreatic body cancer refers to pancreatic cancer with the predominant location of the tumor in the pancreatic body. All 71
Patient background
Age, sex, serum level of CEA, and serum level of CA19-9 were comparable among the 3 groups (Table I).
Surgical procedures
The DP-CAR was associated with a longer operative time, greater blood loss, more blood transfusions, and portal vein resection. During the DP-CAR, 7 of 13 patients underwent combined total gastrectomy to prevent gastric ischemic complications.
Short-term outcomes
No patients undergoing the DP-CAR or DP died as a result of operation. The overall morbidity rate was significantly higher in the DP-CAR group than in the
Discussion
The present study disclosed the difference in surgical results between the DP-CAR and DP for treating T4 pancreatic body adenocarcinomas. There was no in-hospital mortality in either group, although the surgical morbidity was significantly higher in the DP-CAR group than in the DP group (92% vs 60%). The incidence of microscopically curative (R0) resection was significantly lower in the DP-CAR group than in the DP group (31% vs 74%, P = .003). No significant differences were observed in overall
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Supported by a Grant-in-Aid for cancer research from the Ministry of Health Welfare and Labor of Japan.