J.Jpn. Surg. Soc.. 87(9): 1164-1168, 1986

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Report on the annual meeting

PROBLEMS IN DIAGNOSIS AND TREATMENT OF PANCREATIC CANCER

As of Dec. 1985, a total of 282 patients of pancreatic cancer were encountered at our Institution. Resectabilities for carcinoma of head of the pancreas (CH) and body or tail (CBT) were 22% (40/175) and 7% (7/96), respectively. Pancreaticoduodenectomy (PD) was done in 30 of CH, while total pancreatectomy in 10 of CH and one of CBT and distal pancreatectomy in six of CBT. The five year survival rate of CH after resection was 7.8%. There were two long survivors who survived longer than 10 years after PD, but the longest survival period after TP was three years and 10 months.
Most of the patients with small pancreatic cancer (T1) less than 2cm in diameter was accompanied by jaundice. Imaging of ERP, US and CT was useful to locate the tumors. Eight patients out of 11 with resected small cancer had histologic cancer spread more than 2cm with high vein invasion (9/11) and high nodal involvement (6/11). There was no significant difference in three year survival rate after resection between the patients with T1 (29%) and those with tumors larger than 2cm.
Duodenopancreatectomy is possibly a rational precedure to cure well-defined pancreatic cancer of head without capsular invasion, while total pancreatectomy has validity to be done for ilI-defined cancer or for carcinoma with positive capsular invasion.
Liver metastasis was indeed negative factor for longer survival even in the patients whose malignancies were resected.

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