348 Increasing Regionalization of Hepatic Resection in Canada: 1995-2004

R2 in 9.0%.Patients underwent resection at NCI centers 12.3%, other academic hospitals 34.2%, VA facilities 1.2%, and community hospitals 52.2%.Patients were more likely to have ACC if male, white, larger tumor size, no nodal involvement, or pancreatic tail tumors.Five-year survival in resected patients was significantly better than in patients who did not undergo resection: 36.2%vs.10.4%.Stage-specific survival was significantly better for resected ACC vs. adenocarcinoma: I: 52.4%vs.28.4%, II: 40.2%vs.9.8%, III: 22.8%vs.6.8%, and IV: 17.2%vs.2.8%.On univariate analysis, age <65 yrs, well-differentiated tumors, R0 status, and adjuvant chemoradiation were associated with better long-term survival.On multivariate analysis, age <65, well-differentiated tumors, and negative margins (R0 vs. R1/R2) were the only independent prognostic factors.Conclusions: ACC accounts for ~1% of resected pancreatic cancers; however, it carries a considerably better prognosis than pancreatic adenocarcinoma.Tumors are typically larger, but size is not associated with survival and should not preclude resection.Thus, surgical resection with negative margins and consideration of adjuvant therapy is the best chance for long-term survival in these favorable pancreatic cancers.