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Makuuchi et al. J Cancer Metastasis Treat 2018;4:26 Journal of Cancer
DOI: 10.20517/2394-4722.2018.15 Metastasis and Treatment

Review Open Access

Pancreaticoduodenectomy for gastric cancer

Rie Makuuchi, Tomoyuki Irino, Yutaka Tanizawa, Etsuro Bando, Taiichi Kawamura, Masanori Terashima

Division of Gastric Surgery, Shizuoka Cancer Center, Shizuoka 411-8777, Japan.

Correspondence to: Dr. Masanori Terashima, Division of Gastric Surgery, Shizuoka Cancer Center, 1007, Shimonagakubo,
Nagaizumi-Cho, Sunto-Gun, Shizuoka 411-8777, Japan. E-mail: m.terashima@scchr.jp
How to cite this article: Makuuchi R, Irino T, Tanizawa Y, Bando E, Kawamura T, Terashima M. Pancreaticoduodenectomy for
gastric cancer. J Cancer Metastasis Treat 2018;4:26. http://dx.doi.org/10.20517/2394-4722.2018.15
Received: 1 Mar 2018 First Decision: 4 Apr 2018 Revised: 10 Apr 2018 Accepted: 21 May 2018 Published: 7 Jun 2018

Science Editors: Masayuki Watanabe Copy Editor: Jun-Yao Li Production Editor: Huan-Liang Wu

Abstract
Pancreaticoduodenectomy (PD) is performed to achieve an R0 resection for gastric cancer with pancreatic and/or
duodenal invasion. Several retrospective case series have been published, but the sample cohorts in each study were
heterogeneous and small. Moreover, the absence of prospective studies results in a lack of solid evidence that will help
determine who can benefit from this procedure. Although the morbidity and mortality of PD have been reported by most
studies to be acceptable and that the procedure is feasible, these remained to be much higher than those of standard
gastrectomy. Therefore, careful selection of patients should be considered. Based on a review of previous case series
and our own experience, PD appears to be beneficial to patients with gastric cancer with pancreatic invasion when
R0 resection is possible. In addition, multidisciplinary treatment such as neoadjuvant chemotherapy, is anticipated to
improve survival. Nevertheless, considering that prospective randomized studies are difficult to perform, a large-scale
multicenter retrospective cohort study is required to evaluate this highly invasive procedure.

Keywords: Gastric cancer, pancreaticoduodenectomy, multivisceral resection

INTRODUCTION
[1]
Gastric cancer is the fifth most common cancer and is the third leading cause of cancer deaths worldwide .
Its incidence is higher in Eastern Asia, including Japan, Korea, and China, than in Western countries.
Although approximately 50% of the patients in Japan are diagnosed during the early stages of gastric cancer,
[2]
several patients are diagnosed in the advanced stages . For gastric cancer treatment, radical surgical
resection with lymph node dissection is the established standard and complete surgical resection without
residual disease (R0 resection) is the cornerstone. For tumors that invade adjacent organs, combined
resection is necessary for achieving complete tumor clearance.

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
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