{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T23:09:00Z","timestamp":1793142540165,"version":"4.5.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2004,3,22]],"date-time":"2004-03-22T00:00:00Z","timestamp":1079913600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,4,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Mortality rates associated with pancreatic resection for cancer have steadily decreased with time, but improvements in long-term survival are less clear. This prospective study evaluated risk factors for survival after resection for pancreatic adenocarcinoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from 366 consecutive patients recorded prospectively between November 1993 and September 2001 were analysed using univariate and multivariate models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty-eight patients (15\u00b78 per cent) underwent surgical exploration only, 97 patients (26\u00b75 per cent) underwent palliative bypass surgery and 211 patients (57\u00b77 per cent) resection for pancreatic adenocarcinoma. Stage I disease was present in 9\u00b70 per cent, stage II in 18\u00b70 per cent, stage III in 68\u00b77 per cent and stage IV in 4\u00b73 per cent of patients who underwent resection. Resection was curative (R0) in 75\u00b78 per cent of patients. Procedures included pylorus-preserving Whipple resection (41\u00b72 per cent), classical Whipple resection (37\u00b70 per cent), left pancreatic resection (13\u00b77 per cent) and total pancreatectomy (8\u00b71 per cent). The in-hospital mortality and cumulative morbidity rates were 2\u00b78 and 44\u00b71 per cent respectively. The overall actuarial 5-year survival rate was 19\u00b78 per cent after resection. Survival was better after curative resection (R0) (24\u00b72 per cent) and in lymph-node negative patients (31\u00b76 per cent). A Cox proportional hazards survival analysis indicated that curative resection was the most powerful independent predictor of long-term survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Resection for pancreatic adenocarcinoma can be performed safely. The overall survival rate is determined by the radicality of resection. Patients deemed fit for surgery who have no radiological signs of distant metastasis should undergo surgical exploration. Resection should follow if there is a reasonable likelihood that an R0 resection can be obtained.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bjs.4484","type":"journal-article","created":{"date-parts":[[2004,4,12]],"date-time":"2004-04-12T07:01:03Z","timestamp":1081753263000},"page":"586-594","source":"Crossref","is-referenced-by-count":695,"title":["Curative resection is the single most important factor determining outcome in patients with pancreatic adenocarcinoma"],"prefix":"10.1093","volume":"91","author":[{"given":"M","family":"Wagner","sequence":"first","affiliation":[{"name":"Department of Visceral and Transplantation Surgery, University of Berne, Berne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Redaelli","sequence":"additional","affiliation":[{"name":"Department of Visceral and Transplantation Surgery, University of Berne, Berne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Lietz","sequence":"additional","affiliation":[{"name":"Department of Visceral and Transplantation Surgery, University of Berne, Berne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C A","family":"Seiler","sequence":"additional","affiliation":[{"name":"Department of Visceral and Transplantation Surgery, University of Berne, Berne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Friess","sequence":"additional","affiliation":[{"name":"Department of Visceral and Transplantation Surgery, University of Berne, Berne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M W","family":"B\u00fcchler","sequence":"additional","affiliation":[{"name":"Department of Visceral and Transplantation Surgery, University of Berne, Berne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2004,3,22]]},"reference":[{"key":"2021070907193999000_bib1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S1072-7515(99)00075-7","article-title":"Pancreatic cancer: a report of treatment and survival trends for 100 313 patients diagnosed from 1985\u20131995, using the National Cancer Database","volume":"189","author":"Sener","year":"1999","journal-title":"J Am Coll Surg"},{"key":"2021070907193999000_bib2","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1002\/1097-0142(19890901)64:5<1132::AID-CNCR2820640528>3.0.CO;2-V","article-title":"Radical pancreatectomy for ductal cell carcinoma of the head of the pancreas","volume":"64","author":"Manabe","year":"1989","journal-title":"Cancer"},{"key":"2021070907193999000_bib3","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1097\/00000658-199004000-00011","article-title":"Survival after pancreatoduodenectomy. 118 resections without an operative mortality","volume":"211","author":"Trede","year":"1990","journal-title":"Ann Surg"},{"key":"2021070907193999000_bib4","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/0002-9610(91)90371-J","article-title":"Factors influencing survival after pancreaticoduodenectomy for pancreatic cancer","volume":"161","author":"Cameron","year":"1991","journal-title":"Am J Surg"},{"key":"2021070907193999000_bib5","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1002\/(SICI)1097-0142(19960215)77:4<640::AID-CNCR9>3.0.CO;2-K","article-title":"Results of extensive surgery for pancreatic carcinoma","volume":"77","author":"Nagakawa","year":"1996","journal-title":"Cancer"},{"key":"2021070907193999000_bib6","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1056\/NEJMsa012337","article-title":"Hospital volume and surgical mortality in the United States","volume":"346","author":"Birkmeyer","year":"2002","journal-title":"N Engl J Med"},{"key":"2021070907193999000_bib7","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1097\/00000658-198404000-00008","article-title":"Regional pancreatectomy for cancer of the pancreas, ampulla, and other related sites. 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