Reconsidering the boundary of the pancreatic body and tail in pancreatic cancer surgery

Abstract

Twenty-eight cases with pancreatic body and tail cancer were classified into pancreatic tail (group T: 9 patients) and body (group B: 19 patients) cancer divided at the left edge of the aorta as defined by the UICC. In group T, tumor progression was confined only to the surrounding splenic arteries, however, in group B, tumor progression toward the celiac and common hepatic arteries were observed. The 5-year survival rate of group T (60.0%) was better than group B (11.8%) (p=0.054). In 11 cases of group B, the so-called Appleby's operation was performed. However, there was no difference in the survival rate compared with the usual distal pancreatectomy group, only 2 cases of 5-year survival was observed in the so-called Appleby's operation group. In conclusion, the boundary of pancreatic body and tail at the left edge of the aorta can better reflect the prognosis of pancreatic body and tail cancer.