Pancreatic head carcinoma: is pancreatic resection indicated for patients with stage III pancreatic duct cancer?.

BACKGROUND/AIMS This paper examines factors influencing the outcome of patients suffering from unresectable pancreatic carcinoma. MATERIALS AND METHODS One hundred forty-three patients with pancreatic carcinoma were placed into three groups. Group A (n = 56) received pancreatic resection. Group B (n = 30) included patients deemed ineligible for pancreatic resection. Group C (n = 57) was made up of patients deemed ineligible for pancreatic resection who received combined locoregional immuno-chemotherapy. RESULTS Twenty-two patients (36%) from Group A are still living. Average survival is 18.6 months. Survival was dependent on the stage of the disease, the site of origin, and the type of resection. All Group B patients are dead with an average survival of 4.5 months and poor quality of life. Thirty-two patients (56%) from Group C are alive. Average survival is 21 months and they have a much greater quality of life index compared to Group A or B. CONCLUSION Based on the above results, we believe that for patients with Stage III Pancreatic Duct Carcinoma, pancreatic resection should not be the initial treatment option. These patients should be treated first with Locoregional Combined Immunochemotherapy. Then depending upon their response, should be assigned to a subsequent pancreatic resection.