Distal pancreatectomy--does it have a role for pancreatic body and tail cancer.

BACKGROUND/AIMS: Pancreatic resection is the only hope for clinical improvement for patients with carcinoma of the body and tail of the pancreas. However, it is unclear whether palliative pancreatic resection is effective or not for patients with carcinoma of the body and tail of the pancreas. METHODOLOGY: To determine the appropriate treatment for patients with pancreatic body and tail cancer, we analyzed the records of 74 patients with ductal carcinoma of the body or tail of the pancreas who were treated at Kanazawa University Hospital between 1970 and 1995. RESULTS: Using a multivariate Cox proportional-hazard model (factors: age, sex, chemotherapy, radiotherapy, hepatic metastasis, peritoneal dissemination, operative procedure), the presence of hepatic metastasis, peritoneal dissemination, and the type of operative procedures (resection or not) were found to be significant prognostic factors. Surgical resection was the most important prognostic factor. The patients with surgical resection had a significantly higher survival rate than those without resection (p<0.0001). The survival rate of the patients with palliative resections was also significantly higher than that of the patients without resection, except for the patients with advanced liver metastasis (H3). The survival rate of the patients with palliative resections was also higher than that of the patients without resection, even in patients with peritoneal dissemination. CONCLUSIONS: Surgical resection prolongs the average survival for patients with carcinoma of the body and tail of the pancreas, except for the patients with multiple liver metastasis. These data support the role of palliative pancreatectomy in patients with carcinoma of the body and tail pancreas.