Review of pancreatic cancer

In 83 cases of pancreatic cancer (25 resected and 58 non-resected cases) which underwent laparotomy in the Department of General and Gastroenterological Surgery, Osaka Medical College Hospital over the past 11 years, we analyzed symptoms at diagnosis, duration of illness, tumor markers, surgical procedures, and long-term results. In many cases, jaundice was the premonitory symptom of pancreatic cancer. There was no relationship between duration of illness and tumor resectability. In analysis of tumor markers, abnormal CA19-9 levels were noted in 71% of resected cases and 89% of non-resected cases, and abnormal CEA, elastase and amylase levels were found in 38, 46 and 47% of resected cases and 76, 58 and 27% of non-resected cases, respectively. Operative mortality was higher for non-resected cases (22%) than that for resected cases (8%). Long-term results were significantly better in resected cases than non-resected cases. However, 1-, 2- and 3-year survival rates after macroscopic curative resection were 45, 19 and 9%, respectively. Prognosis of patients after absolute non-curative resection was poor, indicating no efficacy of the resection. To improve these very poor surgical results for pancreatic cancer, the early cancer detection and multi-disciplinary therapy seem to be necessary.