Clinical analysis of TS1 carcinoma of the pancreas

Abstract

Abstract:In 40 patients with tumor size (TS)I pancreatic cancer with a TS of 2 cm or less, the tumor was classified as without direct extrapancreatic invasion in 11 patients (ha, group) and as with direct extrapancreatic invasion in 29 patients (t2t 3 group). Ultrasonography (US) and endoscopic retrograde cholangio-pancreatography (ERCP) were useful for the diagnosis, with accuracy rates of 80% and 75%, respectively, in the tla group and 78% and 75% in the t2t 3 group. The accuracy rate of preoperative integrated imaging diagnosis was 83% in the t2t3 group but only 55% in the tla group. All of the t2t 3 patients were stage III or higher and 18% of the ha patients had lymph node metastasis, indicating the need for extended radical operation in TS1 pancreatic cancer. Because standard operation is indicated when the preoperative diagnosis is not pancreatic cancer, accurate preoperative diagnosis is very important. The rate of curative resection and the 5-year survival rate were 100% and 56%, respectively, in the tla group and there were two 5-year survivors. The rate of non-curative resection and the 5-year survival rate were 31% and 35%, respectively, in the t2t 3 group and there were three 5-year survivors. In the light of these findings, it is therefore important to make an accurate diagnosis of ha pancreatic cancer of TS1 pancreatic cancer without direct extrapancreatic invasion. As liver metastasis was frequently observed in both the tla and t2t3 groups, the establishment of effective measures to inhibit liver metastasis is considered urgent to improve the result of TS1 pancreatic cancer surgery.Key words: TS1 (2 cm or less) pancreatic carcinoma, imaging diagnosis, extended radical operation with D2 lymph node dissection, liver metastasis Offprint requests to: T. Hatori

Staging and treatment for patients with pancreatic cancer. How small is an early pancreatic cancer?

“…Small pancreatic cancer was defined as a tumor with a diameter less than 2 cm in 22 papers,10,11,13,16,,26,30 and as a tumor with a diameter less than 1 cm in 3 papers 12,17,25. Fifteen of the 22 papers reported experiences at separate institutions1,3,4,,,,30 (Table 1) while the other 7 papers2,10,11,16,18,19,29 were collective reviews of small pancreatic cancer less than 2 cm in diameter (Table 2). Two of the three papers12,25 on tumors less than 1 cm in diameter were reports from only one institution, and the remaining paper17 was a collective review of small pancreatic cancer less than 1 cm in diameter (Table 3).…”

“…Twenty‐five reports, published in English or Japanese to the end of 1996 described cases of small adenocarcinoma of the pancreas less than 2 cm in diameter, and reported the rates for stage I tumor, lymph‐node metastasis, and/or long‐term survival. The Union International Contre le Cancer (UICC) stage classification,31 Japanese stage classification,32,33 or Hermreck stage classification34 was used in these studies.…”