Department of Internal Medicine, Institute of Gastroenterology College of Medicine Yonsei University, Seoul, Korea
Corresponding author:
Jae Bock Chung,
ABSTRACT
Objectives: Ductal adenocarcinoma of the pancreas is a lethal disease with poor prognosis. 5-year survival of pancreatic adenocarcinoma was less than 5%. To determine which factors effect the prognosis in the patients of pancreatic adenocarcinoma, the authors reviewed the data of the patients who were diagnosed and treated as pancreatic adenocarcinoma and analyzed the difference between survival groups more than 1 year and less than 1year. Method: The records of 242 patients who were diagnosed and treated as pancreatic adenocarcinoma from January 1991 to January 1996 were reviewed retrospectively. Survival and survival time were confirmed by patients interview, letter, hospital chart, and personal contact with the attending physician. Results: 166 of the 242 patients were male and 76 patients female. Mean age of 242 patients was 60.4 years. Overall 1-year survival was 14%. 1-year survival of patients with stage I(n=16) was 54%, stage II(n=37) 19%, stage III(n=63) 17%, and stage IV(n=126) 5%. Median survival time of the patients with ECOG grade 0(n=10) was 14 months, grade 1(n=96) 7 months, grade 2(n=70) 4 months, grade 3(n=45) 2 months, and grade 4(n=20) 1 month. When survival groups more than 1 year(n=34) and less than 1 year(n=208) were compared, the patients of survival group more than 1 year had better general health condition(ECOG grade), less tumor size(2.4±0.7 vs 3.4±2.2 cm), less lymph node involvement(35.3 vs 64.9%) and less distant metastasis(14.7 vs 56.7%) than the patients of survival group less than 1 year. One-year survival of the patients who underwent curative resection(n=23) was 51%, palliative resection(n=33) 25% and no resection(n=186) 7%. The patients of survival group more than 1year were treated by more aggressive and multimodality therapy(operation, chemotherapy, radiotherapy) than the patients of survival group less than 1year. All 5 patients of stage IV who survived more than 1year were belonged to ECOG grade 1. No metastatic lesion was found by radiologic study before operation but metastatic lesions were found at operation in all 5 patients. All 5 patients were treated by adjuvant chemotherapy after operation. Conclusion: The patients of survival group more than 1 year had better general health condition(ECOG grade), less tumor size, less lymph node involvement, less distant metastasis and were treated more aggressive therapy than the patients of survival group less than 1year.
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