Long-term survival in patients with locally advanced colon cancer after en bloc pancreaticoduodenectomy and colectomy.

Abstract

Surgical indications for colon cancer directly invading the pancreas head are controversial. Between 1957 and 2007, a total of 12 patients (8 men) underwent pancreaticoduodenectomy combined with right hemicolectomy for colon cancer involving the pancreas head. 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. Pancreaticoduodenectomy for advanced colon cancer invading the pancreas or duodenum provides favorable long-term survival.