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Japanese Journal of Clinical Oncology 25:37-45 (1995)
© 1995 Foundation for Promotion of Cancer Research

Evaluation of the Effect of Pancreatic Resection in Advanced Pancreatic Cancer with Special Reference Using Hospital-free Survival as a Measure of Quality of Life

Mitsunori Yasue1, Junichi Sakamoto1,, Takeshi Morimoto2, Kenzo Yasui2, Nobuyoshi Kuno3, Kumiko Kurimoto3, Satoshi Teramukai4 and Yasuo Ohashi4

1 Department of Surgery, Aichi Prefectural Hospital Okazaki
2 Department of Gastroenterological Surgery, Aichi Cancer Center Nagoya
3 Department of Gastroenterology, Aichi Cancer Center Nagoya
4 Department of Epidemiology and Biostatistics, School of Health Sciences and Nursing, Unversity of Tokyo Tokyo

For all reprints and correspondence: Junichi Sakamoto, Department of Surgery, Aichi Prefectural Hospital, 18, Kuriyado, Kakemachi, Okazaki, Aichi 444

Received October 28, 1994; accepted February 10, 1995

Comparisons of surgical procedures and the identification of prognostic factors in pancreatic cancer were carried out on 158 patients who underwent surgery in Aichi Cancer Center from 1975 to 1991 for advanced pancreatic ductal adenocarcinoma. Survival and hospital-free survival (HFS),1 which we consider the best general means of measuring quality of life (QOL) in such severe and often fatal disease, were identified as primary end points, and the effect of pancreatectomy, compared with palliative surgery (by-pass operation, etc.) for TNM Stages III and IV pancreatic cancer was evaluated. Both survival and HFS were significantly longer in the group of patients who underwent panreatectomies (R group, n 25) compared to the group without pancreatic resections (NR group, n 35) in Stage III cases. In Stage IV cases, however, no significant difference was observed between the R (n 12) and NR (n 86) groups. From these results, we conclude that an extensive pancreatic resection against Stage III pancreatic cancer may improve prognosis. For Stage IV pancreatic cancers, however, agressive surgery might not always be beneficial either for survival or for QOL

Key Words: Pancreatic cancer • Survival • Hospital-free survival • Pancreatic resection • Prognostic factors


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