AIM:To characterize the factors of the improved survival following combined pancreaticoduodenectomy(PD) and gastrectomy for the treatment of advanced gastric cancer with pancreaticoduodenal region involvement.METHODS:From 1995 to 2004,53 patients with primary gastric cancer were diagnosed with synchronous(n = 44) or metachronous(n = 9) pancreaticoduodenal region involvement.Of these,17 patients(32%) underwent total gastrectomy(TG) or distal subtotal gastrectomy(SG) combined with PD simultaneously.The preoperative demographic,clinical information,clinicopathologic features and the surgical results of these 17 patients were considered as factors influencing survival and were analyzed by the Kaplan-Meier method with log-rank comparison.RESULTS:The actual 1-and 3-year survival rates of these 17 patients after resection were 77% and 34%,respectively,and three patients survived for more than 5 years after surgery.The tumor-free resection margin(P = 0.0174) and a well-differentiated histologic type(P = 0.0011) were significant prognostic factors on univariate analysis.No mortality occurred within one mo after operation,postoperative weight loss of differ-ent degree was present in all the patients with TG and 12 cases had other complications.There were 9(53%) cases of recurrence in 5-48 mo after operation.The survival rate in the palliative and explorative group was significantly(P = 0.0064) lower than in the combined PD group. AIM: To characterize the factors of the improved survival of the following combined pancreaticoduodenectomy (PD) and gastrectomy for the treatment of advanced gastric cancer with pancreaticoduodenal region involvement. METHODS: From 1995 to 2004,53 patients with primary gastric cancer were diagnosed with synchronous (n = Of the 17 patients (32%) underwent total gastrectomy (TG) or distal subtotal gastrectomy (SG) combined with PD simultaneously. Preoperative demographic, clinical information, clinicopathologic features and the surgical results of these 17 patients were considered as factors influencing survival and were analyzed by the Kaplan-Meier method with log-rank comparison. RESULTS: The actual 1-and 3-year survival rates of these 17 patients after resection were 77% and 34%, respectively, and three patients survived for more than 5 years after surgery. The tumor-free resection margin (P = 0.0174) and a well-differentiated histologi c type (P = 0.0011) were significant prognostic factors on univariate analysis .No 病 occurred within one mo after operation, postoperative weight loss of differ-ent degree was present in all the patients with TG and 12 cases had other complications.There were 9 (53%) cases of recurrence in 5-48 mo after operation. The survival rate in the palliative and explorative group was significantly (P = 0.0064) lower than in the combined PD group.