A comparative study on the prognosis of carcinoma of the head, uncinate process and neck of the pancreas after pancreatoduodenectomy

Donghui RAN; Cheng GENG; Ziyan LOU; Linbin RAO; Abuduwaili ATIGU; Xinjian XU

Objective:

To compare the prognosis of pancreatic head cancer, uncinate process cancer and pancreatic neck cancer patients after undergoing pancreatoduodenectomy.

Methods:

The clinical data and follow-up data of 71 pancreatic cancer patients undergoing pancreatoduodenectomy in the First Affiliated Hospital of Xinjiang Medical University were analyzed retrospectively, Kaplan Meier method was used to compare the survival of postoperative patients. COX proportional risk model was used to analyze the survival of three groups of tumor.

Results:

In pancreatic cancer patients, uncinate process cancer and pancreatic neck cancer had more frequent vascular invasion, higher lymph node metastasis rate and lower R 0 resection rate than pancreatic head cancer (all P<0.05). Multivariate COX suggested that vascular invasion ( P=0.018), lymph node metastasis ( P=0.001), tumor site ( P=0.022 in uncinate process, P=0.000 in pancreatic neck) and R 0 resection ( P=0.000) were independent risk factors for prognosis. For pancreatic head cancer the 1-year recurrence rate was 43.8%, 3-year survival rate was 28.1%, median survival time was 20.0 months (95% CI 15.565-24.435). For uncinate process cancer 1-year recurrence rate was 61.5%, 3-year survival rate was 15.4%, median survival time was 14.0 months (95% CI 9.003-18.997) respectively.That was 69.2%, 7.7% and 10.0 months (95% CI 5.303-14.697) respectively for pancreatic neck cancer.

Conclusion:

Compared with pancreatic head cancer, uncinate process cancer and pancreatic neck cancer are associated with poorer prognosis because of frequent early vascular invasion, low R 0 resection rate and early local recurrence.

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