J.Jpn. Surg. Soc.. 83(9): 1039-1042, 1982

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Report on the annual meeting

MODES OF SPREAD OF PANCREATIC CANCER WITH SPECIAL REFERENCE TO LYMPHATIC SPREAD AND CANCER GROWTH IN THE PANCREAS

One hundred 2nd seventeen non-resected, autopsied cases with pancreatic cancer were examined both grossly and microspically. In 18 cases with relatively small (less than 4cm in diameter) tumors of the head, the rate of metastasis to peripancreatic, para-aortic, and distant lymph nodes were 72%, 44%, and 28%, respectively, while blood-borne metastasis occurred in 50% of the cases. Other cases with larger tumor of the head (51 cases) and tumor of the body-tail (48 cases) had more highly and extensive metastatic spread.
2) In 4 autopsied cases with locally resectable cancer of the head of the pancreas, local and lymphatic spread of the cancer were examined microscopically by serial section of surrounding structures, together with pancreas. Lymph node involvement were demonstrared in No. 14b and 13a nodes in all cases and in No. 13b, 14a, and 16 nodes in 3 cases, while local cancerous invasion to nerve plexus, vessels, and connective tissues showed extension far beyond area of involved lymph nodes except paraaortic region.
3) In 21 surgically resected specimens with pancreatic cancer, cancer growth in the pancreas were analysed. The pattern of cancer growth were divided into 4 types: I (well-circumscribed type) in 4 cases, II (invasive type) in 8 cases, III (intraductal spreading type) in 2 cases, IV (mixed type) in 7 cases. Two cases with invasive type of cancer, cancerous invasion was shown on the resected stump of the pancreas.

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