Ductal adenocarcinoma of the body and tail of the pancreas.

BACKGROUND: Carcinoma arising from the body and tail of the pancreas is less frequent than pancreatic head cancer, and its prognosis is known to be worse. This aggressive behavior is reported by few large clinical studies. STUDY DESIGN: We retrospectively reviewed our 24 years experience on adenocarcinoma of the body and tail of the pancreas and analyzed survival and longterm results after resection. Recent large series on cancer of the distal pancreas were also reviewed. RESULTS: Among 148 patients observed, 109 were surgically treated. Resectability rate was 16%; ductal adenocarcinoma in 22% of patients who underwent surgery was resectable. Macroscopic radical resection was achieved in only 16 cases. Overall 5-year survival rate was 2%. In resected cancers the actual 5-year survival rate was 12.5%. Patients with unresectable cancers did not survive more than 17 months. All three patients who survived more than 5 years had a small tumor (T1 according to TNM staging). In the literature, among 360 evaluable resected patients, only 7 survived at 5 years (2%). CONCLUSIONS: The prognosis for patients with adenocarcinoma of the distal pancreas is poor, even after resection of the tumor; however, the results are not substantially different for those reported after resection for pancreatic head carcinoma. Surgical resection can offer longterm survival for patients with localized cancer.