J Korean Med Sci.  2007 Sep;22(Suppl):S79-S85. 10.3346/jkms.2007.22.S.S79.

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

• Jung KW
• Kim MH
• Lee TY
• Kwon S
• Oh HC
• Lee SS
• Seo DW
• Lee SK

• KMID: 1785793
• DOI: http://doi.org/10.3346/jkms.2007.22.S.S79

Abstract

Small pancreatic cancers (longest diameter < or =2 cm) have been regarded as preliminary to early pancreatic cancer, which was thought to be highly curable. During our experience since 1989, we evaluated 542 cases of pancreatic cancer. Among them we found 74 cases of tumors < or =2 cm in diameter, small pancreatic cancer (TS1 pancreatic cancer). Well-differentiated adenocarcinomas (18.9%) and absence of symptoms (8.1%) were more frequent in patients with TS1 than in those with larger pancreatic tumors. Only 16 of the 74 patients (21.6%) with small pancreatic cancers had T1 tumors. According to the International Union Against Cancer (UICC) staging, only 11 patients (14.9%) were stage IA: their 5-yr survival rate was 23.3% and their median survival was 30.0 months. Among these 11 patients, 3 had tumors <1 cm; their median survival time was 30.0 months and their 5-yr survival rate was 50.0%. These findings may indicate that 'small' pancreatic cancer is not equivalent to 'early' pancreatic cancer.

Keyword

Pancreatic Neoplasm

MeSH Terms

Adenocarcinoma/pathology
Adenocarcinoma, Mucinous/pathology
Adenocarcinoma, Papillary/pathology
Adult
Aged
CA-19-9 Antigen/metabolism
Carcinoembryonic Antigen/metabolism
Carcinoma/pathology
Carcinoma, Adenosquamous/pathology
Carcinoma, Pancreatic Ductal/pathology
Female
Humans
Korea/epidemiology
Male
Middle Aged
Neoplasm Staging
Pancreatic Neoplasms/immunology/mortality/*pathology
Prognosis
Survival Rate
Tumor Burden

Figure

• 

  Fig. 1 UICC T factor and survival rate after pancreatectomy for TS1 pancreatic cancer. T1, tumor limited to the pancreas, ≤2 cm in its greatest diameter; T3, tumor extending beyond the pancreas but without involvement of the celiac axis or superior mesenteric artery; T4, tumor involving the celiac axis or superior mesenteric artery (total p value <0.05).

• 

  Fig. 2 JPS T factor and survival rate after pancreatectomy for TS1 pancreatic cancer. T1, tumor limited to the pancreas, ≤2 cm in its greatest diameter; T3, tumor extending into the bile duct, duodenum, or peripancreatic tissue; T4, tumor extending into the adjacent large vessels, extrapancreatic nerve plexus, or other organs (total p value <0.05).

• 

  Fig. 3 JPS N factor and survival rate after pancreatectomy for TS1 pancreatic cancer. The grouping of the lymph nodes is described elsewhere (total p value >0.05).

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  Fig. 4 JPS stage and survival rate after pancreatectomy for TS1 pancreatic cancer (total p value >0.05).

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  Fig. 5 UICC stage and survival rate after pancreatectomy for TS1 pancreatic cancer (total p value <0.05).

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  Fig. 6 Minute cancer subgroup A (carcinoma in situ or size <1 cm with minimal invasion to stroma) vs. subgroup B (tumor size 1-2 cm) and survival rate after pancreatectomy for TS1 pancreatic cancer.

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