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. 1984 Jan;199(1):1–5. doi: 10.1097/00000658-198401000-00001

Comparison of conventional surgical resection, radioactive implantation, and bypass procedures for exocrine carcinoma of the pancreas 1975-1980.

M Morrow, B Hilaris, M F Brennan
PMCID: PMC1353249  PMID: 6419687

Abstract

To examine the efficacy of a variety of procedures for treatment of biopsy proven exocrine adenocarcinoma of the pancreas, a retrospective review of 231 patients surgically treated at a single institution from January 1975 through December 1980 was performed. Thirty-nine patients underwent resection for cure, of which 19 were conventional resection, 33 I125 implantation, 76 biliary or GI bypass, and 83 biopsy alone, a resectability rate of 16.9%. There was one pancreatic fistula in the implant group. Median survival following implant was 8 months (0%, 30-day mortality) and, for conventional resection (n = 19), 17 months with an inhospital mortality of 16%. Median survival excluding inhospital mortality was 17 months for the conventional resection group. For bypass, median survival was 4 months (p = 0.0001 vs. conventional resection) with an inhospital mortality of 14%. Of patients discharged from hospital, 5 of 16 (31%) survived 2 years in the conventional resection group, while 4 of 132 (3%) survived 2 years in the nonresected groups. Only one patient (5% of resected) has survived 4 years in the conventional resection group, although eight others are alive and at risk in this group. Resectability rate for patients referred with adenocarcinoma of the pancreas remains low. The only long-term survivors are in those patients undergoing resection. Local implantation with I125 requires prospective evaluation because of an apparent influence on palliation without significant morbidity.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BOWDEN L., MCNEER G., PACK G. T. CARCINOMA OF THE HEAD OF THE PANCREAS; FIVE YEAR SURVIVAL IN FOUR PATIENTS. Am J Surg. 1965 May;109:578–582. doi: 10.1016/s0002-9610(65)80007-1. [DOI] [PubMed] [Google Scholar]
  2. Brooks D. C., Osteen R. T., Gray E. B., Jr, Steele G. D., Jr, Wilson R. E. Evaluation of palliative procedures for pancreatic cancer. Am J Surg. 1981 Apr;141(4):430–433. doi: 10.1016/0002-9610(81)90135-5. [DOI] [PubMed] [Google Scholar]
  3. Brooks J. R., Culebras J. M. Cancer of the pancreas. Palliative operation, Whipple procedure, or total pancreatectomy? Am J Surg. 1976 Apr;131(4):516–520. doi: 10.1016/0002-9610(76)90167-7. [DOI] [PubMed] [Google Scholar]
  4. Crile G., Jr The advantages of bypass operations over radical pancreatoduodenectomy in the treatment of pancreatic carcinoma. Surg Gynecol Obstet. 1970 Jun;130(6):1049–1053. [PubMed] [Google Scholar]
  5. Edis A. J., Kiernan P. D., Taylor W. F. Attempted curative resection of ductal carcinoma of the pancreas: review of Mayo Clinic experience, 1951-1975. Mayo Clin Proc. 1980 Sep;55(9):531–536. [PubMed] [Google Scholar]
  6. Feduska N. J., Dent T. L., Lindenauer S. M. Results of palliative operations for carcinoma of the pancreas. Arch Surg. 1971 Aug;103(2):330–334. doi: 10.1001/archsurg.1971.01350080246039. [DOI] [PubMed] [Google Scholar]
  7. Fortner J. G. Surgical principles for pancreatic cancer: regional total and subtotal pancreatectomy. Cancer. 1981 Mar 15;47(6 Suppl):1712–1718. doi: 10.1002/1097-0142(19810315)47:6+<1712::aid-cncr2820471442>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]
  8. Herter F. P., Cooperman A. M., Ahlborn T. N., Antinori C. Surgical experience with pancreatic and periampullary cancer. Ann Surg. 1982 Mar;195(3):274–281. doi: 10.1097/00000658-198203000-00006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Knight R. W., Scarborough J. P., Goss J. C. Adenocarcinoma of the pancreas. A ten-year experience. Arch Surg. 1978 Dec;113(12):1401–1404. doi: 10.1001/archsurg.1978.01370240023003. [DOI] [PubMed] [Google Scholar]
  10. Longmire W. P., Jr, Traverso L. W. The Whipple procedure and other standard operative approaches to pancreatic cancer. Cancer. 1981 Mar 15;47(6 Suppl):1706–1711. doi: 10.1002/1097-0142(19810315)47:6+<1706::aid-cncr2820471441>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  11. Moossa A. R., Lewis M. H., Mackie C. R. Surgical treatment of pancreatic cancer. Mayo Clin Proc. 1979 Jul;54(7):468–474. [PubMed] [Google Scholar]
  12. Nakase A., Matsumoto Y., Uchida K., Honjo I. Surgical treatment of cancer of the pancreas and the periampullary region: cumulative results in 57 institutions in Japan. Ann Surg. 1977 Jan;185(1):52–57. doi: 10.1097/00000658-197701000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Shapiro T. M. Adenocarcinoma of the pancreas: a statistical analysis of biliary bypass vs Whipple resection in good risk patients. Ann Surg. 1975 Dec;182(6):715–721. doi: 10.1097/00000658-197512000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Shipley W. U., Nardi G. L., Cohen A. M., Ling C. C. Iodine-125 implant and external beam irradiation in patients with localized pancreatic carcinoma: a comparative study to surgical resection. Cancer. 1980 Feb 15;45(4):709–714. doi: 10.1002/1097-0142(19800215)45:4<709::aid-cncr2820450416>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
  15. Tepper J., Nardi G., Sutt H. Carcinoma of the pancreas: review of MGH experience from 1963 to 1973. Analysis of surgical failure and implications for radiation therapy. Cancer. 1976 Mar;37(3):1519–1524. doi: 10.1002/1097-0142(197603)37:3<1519::aid-cncr2820370340>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
  16. Wilson S. M., Block G. E. Proceedings: Periampullary carcinoma. Arch Surg. 1974 Apr;108(4):539–544. doi: 10.1001/archsurg.1974.01350280141023. [DOI] [PubMed] [Google Scholar]
  17. van Heerden J. A., Heath P. M., Alden C. R. Biliary bypass for ductal adenocarcinoma of the pancreas: Mayo Clinic experience, 1970-1975. Mayo Clin Proc. 1980 Sep;55(9):537–540. [PubMed] [Google Scholar]

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