Improved Survival in Small Pancreatic Cancer

Abstract

Background: Although the incidence of pancreatic cancer is relatively low compared with other tumors (2.4%), the death rate is high. Tumor detection and treatment at an early stage is necessary to improve the poor prognosis of patients, as is demonstrated by some reports showing a 5-year survival rate varying between 19 and 41% for patients undergoing radical pancreatectomy with the highest survival in patients with small tumors. Methods: In our study we retrospectively reviewed the histologic and demographic data of 596 patients who were admitted to the surgical units of the Careggi Hospital (University of Florence-AOC of Florence) between 1988 and 1994 with the incoming diagnosis of pancreatic cancer. Results: Results are reported as the mean ± standard deviation. The postoperative survival rate was calculated by the Kaplan-Meier method and statistical analysis was performed by the log rank test (significance p < 0.05). 247 patients had surgery, 110 with a curative intent. Postoperative mortality was 5.45%. The crude 5-year survival rate for patients who underwent curative surgery was 16.36% (18 patients), but for patients with small lesions confined to the pancreas (T1N0M0, 29 patients) this was even 31.03% (9 patients; p < 0.01, χ² test). Conclusions: Our results indicate that it seems reasonable to consider these cancers as ‘small’, with survival reported in literature from 35 to 41%, so they probably represent the only curable condition at the present time.

Prognostic factors for long-term survival in patients with locally invasive pancreatic cancer

“…The survival of patients with pancreatic cancer could be good if the tumor were to be detected at an early stage ,. Of note, the advantage of surgical resection over chemoradiotherapy has not been confirmed yet, and we have two choices for the treatment of pancreatic cancer.…”

Clinicopathological Aspects of 542 Cases of Pancreatic Cancer: a Special Emphasis on Small Pancreatic Cancer

“…Although the concept of the PanIN (Pancreatic intraepithelial neoplasia) classification (8) has been proposed, many papers still describe pancreatic cancers as small or early. In addition, it has been suggested that radical resection with extensive soft tissue clearance might be more important for prognosis than tumor size alone (9, 10). Degrees of epithelial atypia of the cystic dilated lesions, corresponding to PanIN classifications, may be important in the detection of early-stage pancreatic cancers (11, 12).…”

Small carcinoma of the pancreas is curable: New computed tomography finding, pathological study and postoperative results from a single institute

“…In the many reviews of surgical treatment of pancreatic carcinoma, the overall 5‐year survival rate was around 10% 2,3 , 10,11 . To our knowledge, there are few reports of s‐PC 7,11–18 . To determine whether small, probably early cancers represent the curable condition, we reviewed the clinicopathological features and postoperative results of patients who underwent curative surgery for s‐PC.…”