Operative finding, treatment, and prognosis of carcinoma of the pancreas: An analysis of 267 cases

Abstract

Two hundred sixty-seven laparotomized patients with pancreatic cancer during the period 1947 to 1980 were retrospectively analyzed. In 199 histologically confirmed cases of pancreatic carcinoma the tumor was only local with no invasion to neighboring tissues or distant metastases in 15% of the cases at the primary laparotomy and diagnosis stages, and the survival rates after 1, 3, and 5 years were 22%, 3% and 1%, respectively. The prognosis was a little better if a patient was over 70 years old, duration of symptoms was more than one year, the reason for laparotomy was cholecystopathy, the tumor was stage I, the treatment was a combination therapy of pancreatic resection and postoperative irradiation (with a depth dose of greater than or equal to 4,000 rad). We concluded that, excluding the extremely rare cases of pancreatic carcinoma which are cured with pancreatic resection, the survival of patients after primary operation is correlated nearly in the same way with the given treatment and the stage of the disease. It seems that at present the only possibility of improving the results of treatment in pancreatic carcinoma is to develop the combined treatment of surgery, irradiation, and chemotherapy.

Endoscopic ultrasound guided fine needle aspiration of solid pancreatic lesions: Performance and outcomes

“…There were five false negative cytological cases finally confirmed as ductal adenocarcinoma (n = 4) or cholangiocarcinoma (n = 1). These were classified cytologically as benign (2), suspicious (1) and non-diagnostic (2). In all cases the EUS appearances were suggestive of malignancy.…”

“…Clinical and imaging characteristics often do not distinguish benign from malignant lesions or define the histological subtype of a malignant lesion. Thus a tissue based diagnosis is paramount 1–3 . Whilst the necessity of tissue acquisition is debated in patients who are candidates for surgical resection, we believe it should be mandatory in both surgical and non‐surgical patients as it is central to appropriate therapy.…”

“…Thus a tissue based diagnosis is paramount. [1][2][3] Whilst the necessity of tissue acquisition is debated in patients who are candidates for surgical resection, we believe it should be mandatory in both surgical and non-surgical patients as it is central to appropriate therapy. The main reason for this belief is that not all masses are malignant and not all malignancies are best treated surgically.…”

Diagnostic utility of clinical and biochemical parameters in pancreatic head malignancy patients with normal carbohydrate antigen 19-9 levels

“…Patients bearing malignant tumors in pancreatic head were more likely to present with abdominal pain (63.77% versus 45.95% in our study). Although abdominal pain was nonspecific 18 , it was the most frequent onset symptom in pancreatic cancer 15,19 , and it was proven to have certain relation with tumor location in pancreatic adenocarcinoma 20 . On the other hand, patients with benign lesions did not often appear with abdominal pain until it reached considerable size and gave rise to the obstruction of the pancreatico-biliary duct 21 .…”

Long-Term Survival after Radical Resection for Pancreatic Head and Ampullary Cancer: A Potential Role for the EGF-R

“…Even after a macroscopically radical resection (R-0), distant micrometastases probably already exist [6], and tumor cells are often observed at one or more edges of the resected specimen (R-1) [7, 8]. Reported relevant prognostic variables for survival after resection are: tumor size, lymph node metastasis, histological differentiation, and resection status [9,10,11,12]. Most studies include R-0 as well as nonradical (R-1/R-2) resections.…”