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Is Histological Diagnosis Essential Before Resection of Suspected Pancreatic Carcinoma?

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Abstract

Carcinoma of the pancreas remains a major therapeutic challenge, its incidence is increasing on a global basis (1,2) and over 6000 patients die each year in Britain from the disease (3). Only 15–20% of patients are resectable at the time of diagnosis (4,5). Trede (6) has reported the best actual 5-year survival of 24%. However this was achieved only in those patients with R0 resections. Most authors report a 2-year survival for resected patients in the region of 20% (7,8). In at least 90–95% of patients therefore, palliation of symptoms and optimising quality of life is the realistic aim of treatment.

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References

  1. Muir C, Waterhouse J, Mack T, Powell J, Whelan S. Cancer incidence in five continents, vol V. IARC Lyon, (No. 88).

    Google Scholar 

  2. Fontham ETH, Correa P. Epidemiology of pancreatic cancer. Surg Clin North Am.

    Google Scholar 

  3. Williamson RCN (1988) Pancreatic cancer: the greatest oncological challenge. Br Med J 296:445–446.

    Article  CAS  Google Scholar 

  4. Trede M (1985) The surgical treatment of pancreatic carcinoma. Surgery 97:28–35.

    PubMed  CAS  Google Scholar 

  5. Connelly MM, Dawson PJ, Michaelassi F, Moossa AR, Lowenstein F (1987) Survival in 1001 patients with carcinoma of the pancreas. Ann Surg 122:827–829.

    Google Scholar 

  6. Trede M, Schwall G, Saeger HD (1990) Survival after pancreaticoduodenectomy: 118 consecutive patients without operative mortality. Ann Surg 211:447–458.

    Article  PubMed  CAS  Google Scholar 

  7. Braasch JW, Rossi RL, Watkin E (1986) Pyloric and gastric preserving pancreatic resection. Ann Surg 204:411–418.

    Article  PubMed  CAS  Google Scholar 

  8. Bradbeer, Johnson CD (1990) Pancreaticogastrostomy after panceaticoduodenectomy. Ann R Coll Surg Eng 72:266–269.

    CAS  Google Scholar 

  9. Thomas CR, Ngheim HV, Pelligrini CA (1996) Pancreatic cancer: diagnosis and therapy 1995. In Beger HG et al. (eds) Cancer of the pancreas. Universitatsverlag, pp 419–434

    Google Scholar 

  10. Baumel H, Deixonne B (1986) Exocrine pancreatic cancer. Springer, Berlin Heidelberg New York.

    Google Scholar 

  11. Eelkema EA, Stevens DH, Ward EM (1984) CT Features of non-functioning islet cell carcinoma. AJR 143:943–944.

    PubMed  CAS  Google Scholar 

  12. Moskowitz G (1984) Analysis of abdominal imaging procedures. Gastroenterology 87:1408–1413.

    Google Scholar 

  13. Neiderau C, Grendell JH (1985) Diagnosis of chronic pancreatitis Gastroenterology 88:1973–1995.

    Google Scholar 

  14. Rosch T (1994) Endoscopic ultrasonography. Endoscopy 26:806–807.

    Article  PubMed  CAS  Google Scholar 

  15. Palazzo L, Roseau G, Gayet B (1993) Endoscopic ultrasound in the diagnosis and staging of pancreatic adenocarcinoma. Results of a prospective study with comparison to ultrasonography and CT scan. Endoscopy 25:143–150.

    Article  PubMed  CAS  Google Scholar 

  16. Sironi S, De Cobelli F, Zerbi A et al. (1995) Pancreatic carcinoma: MR assessment of tumor invasion of the peripancreatic vessels. J Comput Assist Tomogr 19:739–744.

    Article  PubMed  CAS  Google Scholar 

  17. Muller MF, Meyenberger C, Bertschinger P et al. Pancreatic tumors: evaluation with endoscopic US, CT, and MR imaging. Radiology 190:745–751.

    Google Scholar 

  18. Megibow AJ, Zhou XH, Rotterdam H et al. (1995) Pancreatic adenocarcinoma: CT versus MR imaging in the evaluation of resectability: report of the radiology diagnostic oncology group. Radiology 195:327–332.

    PubMed  CAS  Google Scholar 

  19. Forsmark CE, Albert CA, Lambiasc L (1993) Diagnostic test for pancreatic carcinoma. Gastrointestinal Endosc 39: A336.

    Google Scholar 

  20. Bakkevold KE, Arnesjo B, Kambestad B (1992) Carcinoma of the pancreas and papilla of Vater: assessment of resectability and factors influencing resectability in stage I carcinomas. A prospective multicentre trial in 472 patients. Eur J Surg Oncol 18:494–507.

    PubMed  CAS  Google Scholar 

  21. Yasuda K, Mukai H, Nakajima M, Kawai K (1993) Staging of pancreatic carcinoma by endoscopic ultrasonography. Endoscopy 25:151–155.

    Article  PubMed  CAS  Google Scholar 

  22. Barthet M, Portal I, Boujaoude J et al. (1996) Endoscopic ultrasonographic diagnosis of pancreatic cancer complicating chronic pancreatitis. Endoscopy 28:487–491.

    Article  PubMed  CAS  Google Scholar 

  23. Tio TL Sie LH, Kallimanis G et al. (1996) Staging of ampullary and pancreatic carcinoma: comparison between endosonography and surgery. Gastroint Endosc 44:706–713.

    Article  Google Scholar 

  24. Weiss SM, Skibber JM, Mohiuddin M, Rosato FE (1985) Rapid intra-abdominal spread of pancreatic cancer. Influence of multiple operative biopsy procedures. Arch Surg 120: 415–416.

    PubMed  CAS  Google Scholar 

  25. Warshaw AL (1991) Implications of peritoneal cytology for staging of early pancreatic cancer. Am J Surg 161:26–30.

    Article  PubMed  CAS  Google Scholar 

  26. Alpern GA, Dekker A (1985) Fine needle aspiration cytology of the pancreas. An analysis of its use in 52 patients. Acta Cytol 2:873–878.

    Google Scholar 

  27. Hall Craggs MA, Lees WR (1986) Fine-needle aspiration biopsy: Pancreatic and biliary tumors. Am J Roent 1986:147;2,399–403.

    Google Scholar 

  28. Celle G, Savarino V, Biggi E (1986) Fine-needle aspiration cytodiagnosis: A simple and safe procedure for cancer of the pancreas. Gast Clin Biol 10:545–548.

    CAS  Google Scholar 

  29. Athlin L, Blind PJ, Angstrom T (1990) Fine-needle aspiration biopsy of pancreatic masses. Acta Chir Scand 156:91–94.

    PubMed  CAS  Google Scholar 

  30. Bognel C, Rougier P, Leclere J et al. (1988) Fine needle aspiration of the liver and pancreas with ultrasound guidance. Acta Cytol 32:22–26.

    PubMed  CAS  Google Scholar 

  31. Geng JZ, Qin PR, Hui LD Po PD (1987) CT guided fine needle aspiration biopsy of biliopancreatic lesions: Report of 30 cases. Jpn J Surg 17:461–464.

    Article  PubMed  CAS  Google Scholar 

  32. Nakamura R, Machado R, Amikura K et al. (1994) Role of fine needle aspiration cytology and endoscopic biopsy in the preoperative assessment of pancreatic and peripancreatic malignancies. Int J Pancreatol 16:17–21.

    PubMed  CAS  Google Scholar 

  33. Walton AJ, Willcox W, Dods EC (1933) Chronic pancreatitis. Trans Med Soc Lond 56:220.

    Google Scholar 

  34. Pauline-Netto A, Dreiling DA, Baronofsky ID (1960) The relationship between pancreatic calcification and pancreatic cancer Ann Surg 151:530–537.

    Article  Google Scholar 

  35. Neiderau C, Neiderau MC, Heintges T, Luthen R (1996) Relationship between chronic pancreatitis and pancreatic carcinoma. In: Begert HG et al. (eds) Cancer of the pancreas. Universitatsverlag, pp 9–15.

    Google Scholar 

  36. Lowenfels AB Maisonneuve P Cavallini G et al. (1993) Pancreatitis and the risk of pancreatic cancer. N Engl J Med 328:1433–1437.

    Article  PubMed  CAS  Google Scholar 

  37. Bramhall SR, Allum WH, Jones et al. (1995) Treatment and survival in 13 560 patients with pancreatic cancer, and incidence of the disease, in the West Midlands: an epidemiological study Br J Surg 82:111–115.

    Article  PubMed  CAS  Google Scholar 

  38. Cameron JL, Crist DW, Sitzmann JV et al. (1991) Factors influencing survival after pancreaticoduodenectomy for pancreatic adenocarcinoma. Am J Surg 161:120–125.

    Article  PubMed  CAS  Google Scholar 

  39. Pellegrini CA, Heck CF, Raper S, Way LW (1989) An analysis of the reduced morbidity and mortality rates after pancreaticoduodenectomy. Arch Surg. 124:778–781.

    PubMed  CAS  Google Scholar 

  40. Tsuchiya R, Noda T, Harada N (1986) Collective review of small carcinomas of the pancreas. Ann Surg 203:77–81.

    Article  PubMed  CAS  Google Scholar 

  41. Baumel H, Huguer M, Manderscheid JC, Fabre JM, Houry S, Fagot H (1994) Results of resection of cancer of the exocrine pancreas: a study from the French Association of Surgery. Br J Surg 81:102–107.

    Article  PubMed  CAS  Google Scholar 

  42. Van Heerden JA (1984) Pancreatic resection for carcinoma of the pancreas Whipple vs total pancreatectomy: an institutional perspective. World J Surg 8:880–888.

    Article  PubMed  Google Scholar 

  43. Funovics JM, Karner J, Pratschner T, Fritsch A (1989) Current trends in the management of carcinoma of the pancreatic head. Hepatogastroenterology 36:450–455.

    PubMed  CAS  Google Scholar 

  44. Mosca F, Guilianomi PC, Balestracci T et al. (1994) Preservation of the pylorus in duodeno-cephalo-pancreatectomy in pancreatic and periampullary tumours. Chir Ital 46:59–67.

    PubMed  CAS  Google Scholar 

  45. Bodner E (1988) Achievements in tumour surgery in tumours of the pancreas. Langenbecks Arch Chir 2:133–8.

    PubMed  Google Scholar 

  46. Buchler MW, Friess H, Muller MW, Wheatley AM, Beger HG (1995) Randomised trial of duodenum-preserving pancreatic head resection versus pylorus-preserving Whipple in chronic pancreatitis. Am J Surg 169:65–69.

    Article  PubMed  CAS  Google Scholar 

  47. Izbicki JR, Bloechle C, Knoefel WT, Kuechler T, Binmoeller KF, Broelsch CE (1995) Duodenum-preserving resection of the head of the pancreas in chronic pancreatitis. A prospective randomised trial. Ann Surg 4:350–358.

    Article  Google Scholar 

  48. Moossa AR (1982) Pancreatic cancer. Approach to diagnosis, selection for surgery and choice of operation. Cancer 50:2689–2698.

    PubMed  CAS  Google Scholar 

  49. Johnson CD (1991) Why resect pancreatic cancer? In: Johnson CD, Imrie CW (eds) Pancreatic disease. Springer, London, pp 97–102.

    Google Scholar 

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© 1999 Springer-Verlag London Limited

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Carter, C.R., Imrie, C.W. (1999). Is Histological Diagnosis Essential Before Resection of Suspected Pancreatic Carcinoma?. In: Johnson, C.D., Imrie, C.W. (eds) Pancreatic Disease. Springer, London. https://doi.org/10.1007/978-1-4471-0801-6_34

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  • DOI: https://doi.org/10.1007/978-1-4471-0801-6_34

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-1205-1

  • Online ISBN: 978-1-4471-0801-6

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