Small carcinoma of the pancreas. Clinical and pathologic evaluation of 17 patients

✍ Scribed by Tadao Manabe; Tadashi Miyashita; Gakuji Ohshio; Atsushi Nonaka; Takashi Suzuki; Keigo Endo; Masaji Takahashi; Takayoshi Tobe

• Publisher: John Wiley and Sons
• Year: 1988
• Tongue: English
• Weight: 592 KB
• Volume: 62
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19880701)62:1<135::aid-cncr2820620123>3.0.co;2-t

✦ Synopsis

The clinical and pathologic characteristics of 17 small carcinomas (less than 2 cm in diameter) of the pancreas are reviewed in this article. All the tumors were located in the head of the pancreas, and the clue to the diagnosis was jaundice in ten patients and abdominal pain in seven. Carcinoembryonic antigen (CEA) and CA 19-9 were not reliable markers for detecting small carcinomas of the pancreas. Ultrasonography (US), computerized tomography (a), percutaneous transhepatic cholangiography (PTC), and endoscopic retrograde cholangiopancreatography (ERCP) were useful diagnostic tools. Lymph node metastases were found in 41% of affected patients, capsular invasion in 248, retroperitoneal invasion in 2496, and portal system involvement in 29%. In five patients the carcinoma was Stage I; in eight patients, Stage II; in two patients, Stage 111, and in two patients, Stage IV. Fifteen patients with Stages I to 111 and one patient with Stage IV underwent curative pancreaticoduodenectomy or total pancreatectomy, and one patient with liver metastasis and Stage IV underwent noncurative pancreaticoduodenectomy. The cumulative 4-year survival rate was 37%. Although four patients with Stage I disease lived for more than 48 months, the survival period of the 12 patients with Stages I1 to IV disease was less than 25 months. Thus, small carcinoma of the pancreas is not always curable; however, a small, localized lesion without any extratumoral extension can be resected with a chance of cure.