Long-term survival following radical and palliative treatment of patients with carcinoma of the pancreas and papilla of Vater--the prognostic factors influencing the long-term results. A prospective multicentre study.

Between 1984-1987, 472 Norwegian patients with histologically or cytologically verified adenocarcinoma of the pancreas (n = 442) and papilla of Vater (n = 30) were prospectively accrued. Radical surgery, i.e. Whipple's procedure (n = 80) or total pancreatectomy (n = 28) were performed in 19% and 80% of patients with pancreatic and papilla carcinoma, respectively. The 1- and 5-year survival rate of patients with pancreatic and papilla carcinoma were 15 and 0.2%, median survival 4.5 months; and 66 and 15%, median survival 17 months, respectively. The corresponding results following radical surgery of pancreatic carcinoma were 45 and 1%, median survival 11.4 months; of papilla carcinoma 78 and 20%, median survival 38.1 months. Radical surgery or a palliative bypass of pancreatic carcinoma were followed by a mean survival of 20.1 vs 9.1 months (P = 0.03) in Stage I and 15.1 vs 7.5 months (P = 0.004) in Stage III, respectively. A Whipple's operation and total pancreatectomy were followed by a mean survival of 16.7 and 18.3 months (P = 0.5), respectively. Dismal prognostic factors were: a distal tumour site, high TNM stage grouping and weight loss. Beneficial factors were a high Karnofsky's index and radical surgery.