Analysis of long-term survivors after surgical resection for invasive pancreatic cancer

Pancreatic cancer remains a lethal disease. Although there are many reports on the survival rates of pancreatic cancer patients after surgical resection, the clinicopathological characteristics that influence long-term survival over 5 years remain controversial. Here, we clarify the favourable prognostic factors for long-term survival. One hundred and eighty-two patients with pancreatic cancer underwent surgical resections from 1981 to 1997 in our department. Among them, eight patients survived for at least 5 years after the surgery. The clinicopathological characteristics of the eight long-term survivors who underwent radical resections were studied retrospectively. R0 surgical resections, including five combined with portal vein resections (62.5%), were achieved in these eight patients. Negative invasions of the major regional artery (seven of eight, 87.5%) and to the extrapancreatic nerve plexus (seven of eight, 87.5%), and N0 or N1 lymph node metastasis (7 of 8, 87.5%) were detected as clinicopathological features of long-term survivors in our study. No exposure of carcinoma at the dissected surface and cut end (seven of eight, 87.5%) was characteristically confirmed by pathology. Portal vein invasion was seen in three of the eight patients (37.5%). For long-term survival in cases of pancreatic cancer, complete R0 resections should be performed and negative invasions in the major regional arteries and to the extrapancreatic plexus of the nerve were necessary. No invasion to the portal vein was not necessarily required if R0 was achieved by combined resection of the portal vein.