The prognosis for pancreatic cancer is unfavorable. After the imposition of biliodigestive anastomosis, the average survival is about 6 months. The prognosis for acinar-cell cancer is worse than in the case of protocol, because the regional lymph nodes are affected earlier. The tumor is resectable only in 5-20% of patients.
Mortality after radical surgery is 15-20%, but recently it has been possible to reduce it to 5% in specialized centers where much more operations are performed and surgeons have a lot of experience. In a recent report from one specialized center after 145 pancreatoduodenal resections, there were no lethal outcomes. However, this is an exceptional case.
Parallel to the reduction in postoperative mortality, the five-year survival rate increased to 20%. Perhaps this reflects an earlier diagnosis due to the use of modern visualization methods of research or is a consequence of the selection for surgery of patients with less common lesions. However, the problem of combating tumor recurrence is still not solved. Total pancreatectomy does not allow to achieve a longer life expectancy compared with a smaller pancreatoduodenal resection by Whipple and causes deficiency of the exocrine function of the gland and severe diabetes.
In general, the prospects for pancreatic cancer are unfavorable: in one study of 912 patients in 3 years 23 were alive and only 2 patients could be considered cured.
The prognosis for cancer of the ampulla is more favorable, the five-year survival after radical surgery with a tumor that does not spread beyond the sphincter of Oddi was 85%, and with more severe invasion - 11-25%. The method of choice is pancreatoduodenal resection. In some cases, local excision of the tumor can be performed.
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