Research Article Open Access
Journal of Surgery
[Jurnalul de Chirurgie]
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ISSN: 1584-9341
Volume 13 • Issue 2 • 3
J Surgery, an open access journal
ISSN: 1584-9341
Keywords: Pancreatic cancer; Pancreatectomy; Survival
Introduction
Pancreatic cancer is one of the most lethal malignancies worldwide,
and ranks fourth in the total number of deaths related to cancer in
patients of both genders. Moreover, in 2013 the United States registered
about 45,000 new cases, and reported that the number of expected deaths
was very similar to the number of new cases. Also, the median overall
survival at 5 years is between 2 and 6% [1].
Also, adenocarcinoma of the pancreas is the most common type of
pancreatic neoplasm, with all of its subtypes accounting for 85% of cases
[1,2].
Currently, curative treatment is only possible in cases of resectable
disease and during the initial stages [3]. Still, although complete surgical
resection is the only potential curative approach of this disease, it can
only be performed in 10 to 20% of patients, since most individuals
present with advanced disease upon diagnosis [3,4]. Moreover, afer
surgical resection, 7 to 25% of patients have a 5-year survival rate [5],
with better results in individuals which undergo curative resection (R0)
[6].
Te prognosis for the patients with pancreatic cancer and which
have indication for the resection with curative intent is determined
by the lymphatic metastasis, the invasion of vascular walls and the
peripancreatic nerve plexus or also by the degree of the micrometastases
in nearby tissues and organs.
As we mentioned before, unfortunately 95% of patients come to the
doctor when the cancer is advanced and unresectable [7-9]. Moreover,
in the recent decades the development of surgical techniques have only
improved postoperative mortality, without having any signifcant impact
on the survival, with specialized pancreatic surgery centres reporting a
mortality below 5% [10,11].
Approximately 60% of pancreatic cancers have cephalic location. With
the reduction of operative mortality afer duodenopancreatectomies,
improved survival rates of 30% were reported [12], which is three times
higher than previously published results [13,14].
*Corresponding author: Mihaela Blaj, MD, PhD, Department of Anesthesiology,
Grigore T Popa University of Medicine and Pharmacy, “St Spiridon” Hospital, Bd.
Independentei No 1, Iasi, Romania, Tel : + 40 (0) 232 24 08 22; E-mail: miblaj@yahoo.com
Received December 15, 2016; Accepted January 13, 2017; Published January
20, 2017
Citation: Timofte D, Blaj M, Petrariu F, Ionescu L, Ochiuz L. Survival Prediction for
Romanian Patients with Pancreatic Cancer. Journal of Surgery [Jurnalul de chirurgie].
2017; 13(2): 59-61 DOI: 10.7438/1584-9341-13-2-3
Copyright: © 2017 Timofte D, et al. This is an open-access article distributed under
the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author and
source are credited.
Abstract
Pancreatic cancer is one of the most lethal malignancies worldwide and in some of the latest statistics ranks fourth
in the total number of deaths related to cancer in patients of both genders. Currently, curative treatment is only possible
in cases of resectable disease and during the initial stages. Still, although complete surgical resection is the only
potential curative approach of this disease, it can only be performed in 10 to 20% of patients, since most individuals
present with advanced disease upon diagnosis. Moreover, in the recent decades the development and improvement of
surgical techniques have only improved postoperative mortality, without having any signifcant impact on the survival,
with specialized pancreatic surgery centres reporting mortality below 5%. In this way, in the present study conducted
on 188 patients from the “St. Spiridon” Clinical Emergency Hospital Iasi, we were interested in determining the survival
rates in pancreatic cancer, as well as looking at the staging criteria for adenocarcinoma of the pancreas that follows
the tumor/node/metastasis (TNM) system and the correlations between any of these stages and the overall survival.
Weibull distribution was used to estimate the overall survival. Reduced survival in pancreatic cancer was found to
be within the limits found in the published literature: 41.7% at 1 year, 8.7% at 3 years and 1.9% at 5 years. Still, no
signifcant correlation was found between any of the disease stages and the overall survival.
Survival Prediction for Romanian Patients with Pancreatic Cancer
Daniel Timofte
1
, Mihaela Blaj
2
*, Florin Petrariu
3
, Lidia Ionescu
1
and Lăcrămioara Ochiuz
1
1
Department of Surgery, Grigore T Popa University of Medicine and Pharmacy, Iasi, Romania
2
Department of Anesthesiology, Grigore T Popa University of Medicine and Pharmacy, Iasi, Romania
3
Department of Pathology, Grigore T Popa University of Medicine and Pharmacy, Iasi, Romania
However, early results improvement (decreased mortality, increase
resectability rate) and the long-term survival are diferent aspects and
it seems that sometimes there is no causal relationship between them.
Moreover, some surgeons are not fully confdent in these sudden
improvements of the survival parameters, as it was suggested by several
authors, an increase need for the anatomopathological reconfrmation of
the original diagnosis, while other authors have proposed standardized
methods of evaluation and reporting systems of survival data and a clear
delimitation for the subgroups of patients [15].
For now, surgical resection is still the best chance to prolong the
disease-free interval. In addition, with all the development in perioperative
management and despite the reduction in operative mortality
corresponding to more aggressive resections, the literature showed no
appreciable improvement for this disease over the past 20 years [16].
In this way, in the present study conducted on 188 patients from
the local Clinical Emergency Hospital “Sf. Spiridon” Iasi, Romania, we
were interested in determining the survival rates in pancreatic cancer,
as well as looking at the staging criteria for adenocarcinoma of the
pancreas that follows the tumor/node/metastasis (TNM) system and
the correlations between any of these stages and the overall survival.
Materials and Methods
Tis study was conducted on 188 patients from Clinical Emergency
Hospital “Sf. Spiridon” Iasi, Romania, all with solid form of pancreatic