Influence of the adjuvant therapy on the survival of patients with stage II pancreatic carcinoma.

This study aimed to investigate the effect of adjuvant therapy on the treatment of stage II pancreatic carcinomas. The clinical data of 139 cases of stage II pancreatic carcinoma were analyzed retrospectively. The overall 1-, 3-, and 5-year cumulative survival rates of 139 patients were 40%, 6%, and 3%, respectively, and the median survival time (MST) was 279 days. The MST was 399 days for those with adjuvant therapy, 210 days for those without adjuvant therapy, 390 days for the radical resection group, 270 days for the bypass operation and laparotomy group, and 132 days for the nonsurgical group. The adjuvant therapy could not prolong the survival time and decrease the liver metastasis rate of the patients with stage II carcinoma significantly in radical resection group (P>0.05). In the bypass operation and laparotomy group and nonsurgical group, the adjuvant therapy could improve the survival of the patients significantly (P<0.05); however, the survival rate was not significantly different among systemic venous chemotherapy, radiation therapy, interventional therapy, and combination therapy (P>0.05); or between gemcitabine (GEM) regimen and 5-fluorouracil regimen (P>0.05); or between GEM monotherapy and GEM combined with platinum/capecitabine (P>0.05). The proper adjuvant therapy can be suggested according to the general condition of the patients after radical resection for stage II pancreatic carcinoma. Chemotherapy combined with radiation should be applied actively for the patients whose cancerous tissues were not radically resected. The clinical efficacy of GEM combined with platinum/capecitabine is relatively better than GEM.

Clinical study of laparoscopic versus open hepatectomy for malignant liver tumors.

BACKGROUND: The number of reported laparoscopic hepatectomies for liver malignancy is increasing, but comparative data on the survival outcomes between the patients who have undergone laparoscopic hepatectomy versus open surgery are still lacking. METHODS: We compared 31 laparoscopic liver resections with 31 open liver resections in a pair-matched retrospective analysis with the aim of evaluating the intraoperative hazards, recovery, and survival outcomes of these procedures for liver cancer. The laparoscopic group and the open group were matched for age, sex, the size and location of the tumor, and the presence or absence of cirrhosis. RESULTS: Thirty cases in the laparoscopic group were performed successfully while one case was converted to open surgery due to intraoperative hemorrhage. The length of hospital stay was 7.5 (5-15) days, which was significantly shorter than those in open group (p < 0.01). The mean operative time and blood loss in the laparoscopic group were 140.1 (60-380) min and 502.9 (50-2000) ml, respectively, which were lower than those in open group but without significant difference. There were no operative complications and no deaths in the laparoscopic group. The mean and median survival times of laparoscopic group were 59.3 and 70 months, compared with 49.4 and 60 months in the open group, respectively. The 1-, 3-, 5-year survival rates in the laparoscopic group were, respectively, 96.55%, 60.47%, and 50.40%, and 96.77%, 68.36%, and 50.64% in the open group. By log-rank test, these two survival curves were not significantly different (p = 0.8535). CONCLUSION: This study shows that laparoscopic hepatectomy for liver malignancy in selected patients is a safe, effective, and oncologically efficient procedure with better short-term results and similar survival outcomes to open hepatectomy for liver malignancy after midterm follow-up.