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HPB Surgery - Volume 7 1993, Issue 1, Pages 1-14



Department of Surgery, Division of Surgical Oncology, Mount Sinai Medical Center, New York, New York, USA

Division of Surgical Oncology, Mount Sinai Medical Center, Dept of Surgery- Box 1259, 1 Gustave L. Levy Place, New York 10029, New York, USA

Accepted 21 January 1993

Copyright © 1993 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We have examined the histopathological factors affecting the degree of local spread, regional lymphnode RLN metastases, and overall survival O.S. in a group of 39 cases of resected carcinoma of theexocrine pancreas. Although the mean O.S. for the group was 14.3 months, resected patients withoutRLN involvement had a mean survival of 24 months. In contrast the mean O.S. rate was 8 months forpatients with RLNs involved. Size, tumor location, and histological grade were compared to RLNinvolvement and O.S. The mean size of primary tumor did not differ significantly between patients withor without RLN's r.1 versus 4.6cms. However, 7 or 8 T1 tumors were <4cm and 35% of tumors <4cmwere T1 lesions. In contrast, only of 17 tumors 6% >4cm was T1. Histological grade was correlated with nodal status and O.S. There was a significant difference between histological grade and thepresence of metastatic lymph nodes G1, 37% positive, G2-4.50% positive. Patients with welldifferentiated tumors had a mean survival of 21 months compared to a mean survival of 10 months forless differentiated tumors p<0.05. This difference was even more significant when stratified for nodalstatus. The patients with well differentiated tumors and no RLN involvement had a mean survival of32.5 months compared to 8.6 months for well differentiated tumors with RLN involvement. Insummary, we have shown that size, histological grade, and local spread predict for nodal status.However, specific patient subsets G1, node negative may exhibit an excellent survival when curativepancreas resection is successful.





Autor: S. T. Brower, R. M. Newman, D. Pertsemlidis, I. Kreel, and A. H. Aufses Jr.

Fuente: https://www.hindawi.com/



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