[Early cancer of the exocrine pancreas: diagnosis and prognosis]

Early pancreatic carcinoma is defined as a tumor of less than 2 cm in diameter, limited to the pancreas without extension to adjacent structures or organs and without lymph-node and distant metastasis (T1a, N0, M0). In analysing 693 pancreatic cancer patients seen at the Surgical Clinic of Erlangen since 1969 we found only 3 early lesions (0.4%). There is a variety of diagnostic signs like unexplained abdominal pain, the development of pancreatic insufficiency, weight loss in excess of 10%, sudden onset of diabetes and elevation of serum and urine amylase. These early symptoms should be clarified by special pancreatic screening tests (ERCP, CT, US, angiography). CT and US alterations may be missing, because of the small tumor size. The proof of a pancreatic duct stenosis indicates laparotomy and resection. One of three of our patients survived longer than 6 years without recurrence. As reported, the 5-year-survival rate of early pancreatic cancer is 86%.