PMID- 2354408
OWN - NLM
STAT- MEDLINE
DCOM- 19900726
LR  - 20220316
IS  - 0008-543X (Print)
IS  - 0008-543X (Linking)
VI  - 66
IP  - 1
DP  - 1990 Jul 1
TI  - Patterns of failure after curative resection of pancreatic carcinoma.
PG  - 56-61
AB  - Thirty-six patients underwent curative resection of a primary pancreatic 
      carcinoma from January 1977 to September 1987; 26 had Whipple resections, seven 
      had total pancreatectomies, and three had distal pancreatectomies. Twenty-six 
      patients manifested recurrent disease, four died of intercurrent disease, and six 
      were apparently cured. Median survival was 11.5 months with actuarial survival at 
      2 and 5 years of 32% and 17%, respectively. Of the eventual recurrences, 19% were 
      local only (pancreatic bed, regional nodes, adjacent organs, and immediately 
      adjacent peritoneum) and 73% had a component of local failure. All patients 
      failing did so with a component in the intraabdominal cavity. Peritoneal (42%) 
      and hepatic failures (62%) were common. Extraabdominal metastases were documented 
      in only 27%, but never as a sole site. Fourteen patient and tumor characteristics 
      were evaluated for any relationships with failure or survival. No single variable 
      independently predicted for local failure. However, a group of three (age greater 
      than 60 years, T2 or T3 stage, and location of tumor in the body or tail) was 
      associated with a substantial local failure risk (85% of all patients with local 
      failure). Multivariate analysis showed that low tumor grade (P = 0.002), female 
      sex (P = 0.002), and adjuvant radiation (P = 0.02) were all independent 
      predictors of prolonged survival. Ten patients were treated in an adjacent 
      setting. Those given 55 Gy or greater had improved local control (50% versus 25%) 
      and cure (33% versus none) when compared with patients treated to lower doses. 
      The authors conclude that local failure after curative resection remains a 
      significant problem and further efforts to improve local control are warranted. 
      However, peritoneal and hepatic relapses occur frequently. Thus, adjuvant 
      treatment strategies using wide-field radiation techniques or intraperitoneal 
      therapy, in combination with local tumor bed irradiation and chemotherapy, should 
      be explored.
FAU - Griffin, J F
AU  - Griffin JF
AD  - Department of Radiation Oncology, Kansas University Medical Center, Kansas City 
      66103.
FAU - Smalley, S R
AU  - Smalley SR
FAU - Jewell, W
AU  - Jewell W
FAU - Paradelo, J C
AU  - Paradelo JC
FAU - Reymond, R D
AU  - Reymond RD
FAU - Hassanein, R E
AU  - Hassanein RE
FAU - Evans, R G
AU  - Evans RG
LA  - eng
GR  - CA-12644/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Cancer
JT  - Cancer
JID - 0374236
SB  - IM
MH  - Adenocarcinoma/mortality/pathology/*surgery
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pancreatic Neoplasms/mortality/pathology/*surgery
MH  - Retrospective Studies
EDAT- 1990/07/01 00:00
MHDA- 1990/07/01 00:01
CRDT- 1990/07/01 00:00
PHST- 1990/07/01 00:00 [pubmed]
PHST- 1990/07/01 00:01 [medline]
PHST- 1990/07/01 00:00 [entrez]
AID - 10.1002/1097-0142(19900701)66:1<56::aid-cncr2820660112>3.0.co;2-6 [doi]
PST - ppublish
SO  - Cancer. 1990 Jul 1;66(1):56-61. doi: 
      10.1002/1097-0142(19900701)66:1<56::aid-cncr2820660112>3.0.co;2-6.