Real Five Year Survival after Radical Surgery for Pancreatic Carcinoma:Can It Be Predicted with the Usual Prognostic Factors?

Introduction Surgery of pancreatic adenocarcinoma with curative intent is the only treatment that offer a long-term survival possibility, with a reported 5-year overall survival rate ranging from 15% to 25%. However, it is only an estimation of long term survival in the majority of reports that could be higher than expected. Our aim is to report the real 5-year overall survival rate based on a large series from a single center and match it with similar reports. Material and methods This is a retrospective analysis of patients with pancreatic adenocarcinoma presenting with 5-year survival rate after the operation performed between 2004 and 2010. We also performed a review of the literature searching for similar series to compare to. Results A total of 128 patients had pancreatic adenocarcinoma resection. Seven patients were lost during the follow up and 4 passed in the early post operative period. The 5-year survival rate of the series is 7.69% (9/117). The analysis of our series and the 8 similar series (388 patients) found in literature shows that some of the well known bad prognostic factors as positive lymph node, poor differentiation grade, R1 resection may be present in these patients. None of long surviving patients was in post operative AJCC stage III and IV: it was the only bad prognostic factor. Conclusions Well known bad prognostic factors can be singled-out in patients with actual 5-year post pancreatectomy survival rates. We realize that the coexistence with some bad prognostic factors should be never taken in account to refute the potential curative surgical treatment except for T4 and/or M1 stage diagnosis.