Department of Gastroenterological Surgery, Cancer Institute Hospital, Tokyo, Japan, akio.saiura@jfcr.or.jp.
PURPOSE: Surgical indications for colon cancer directly invading the pancreas head are controversial. METHODS: Between 1957 and 2007, a total of 12 patients (8 men) underwent pancreaticoduodenectomy combined with right hemicolectomy for colon cancer involving the pancreas head. RESULTS: Mean age was 58 (range, 34-77) years. Fistula formation was observed in five patients (41 percent) preoperatively. Tumor involvement was duodenum only (n = 4), duodenum/pancreas (n = 3), stomach/pancreas (n = 1), duodenum/stomach (n = 2), duodenum/liver (n = 1), and pancreas only (n = 1). Only one postoperative death was encountered. Histologic examination showed malignant invasion to the pancreas head in nine cases (75 percent). Overall one-year, three-year and, five-year survival rates after surgery were 75, 66, and 55 percent, respectively. Five patients (41 percent) survived for more than ten 10 years. CONCLUSIONS: Pancreaticoduodenectomy for advanced colon cancer invading the pancreas or duodenum provides favorable long-term survival.
