@article{oai:nagasaki-u.repo.nii.ac.jp:00010166,
 author = {Nanashima, Atsushi and Tobinaga, Syuuichi and Abo, Takafumi and Hatano, Kazuhiko and Takeshita, Hiroaki and Nonaka, Takashi and Hidaka, Shigekazu and Tanaka, Kenji and Kunizaki, Masaki and Sawai, Terumitsu and Yasutake, Toru and Nagayasu, Takeshi},
 issue = {115},
 journal = {Hepato-gastroenterology},
 month = {May},
 note = {Background/Aims: Surgical resection is a radical treatment option for pancreatic carcinoma (PC); however, it is still difficult to cure and patient prognosis is poor at this stage. Methodology: We examined the demographics, surgical records and outcome in 64 patients with hilar PC undergoing surgical resection. Results: Pancreatoduodenectomy (PD) was carried out in 48 patients, distal pancreatectomy (DP) in 14 and total pancreatectomy in two. Postoperative complications were observed in 18 patients (28%) but no hospital deaths. All stage I patients showed carcinoma in situ of intraductal papillary mucinous carcinoma (IPMC). Postoperative adjuvant chemotherapy was performed in 15 patients (23%) using gemcitabine or S-1. Cancer recurrence was observed in 36 patients (56%) and 31 died of carcinoma. The 5-year cancer-free and overall survival rate was 12% and 14%, respectively. CA19-9 level, morphological type, T category, lymph node metastasis, extrapancreatic nerve plexus invasion, retropancreatic tissue invasion, distal bile duct invasion, duodenal invasion and arterial system invasion were significant poor prognostic factors; however, portal vein system invasion was not significantly associated with prognosis. Cancer infiltration at bile duct cut-end and dissected peripancreatic tissue margin and presence of residual tumor showed a poor prognosis. Surgical prognosis in only non-invasive IPMC was satisfactory.
Conclusions: Radically extended surgical resection is necessary and newly effective adjuvant chemotherapy is a promising modality to improve patient survival in PC patients., Hepato-gastroenterology, 59(115), pp911-915; 2012},
 pages = {911--915},
 title = {Evaluation of Surgical Resection for Pancreatic Carcinoma at a Japanese Single Cancer Institute},
 volume = {59},
 year = {2012}
}