TITLE:
Characteristics of Small Pancreatic Carcinoma: Neural Invasion is Associated with Tumor Recurrence
AUTHORS:
Hideki Izumi, Hisamichi Yoshii, Masaya Mukai, Eiji Nomura, Naoki Yazawa, Daisuke Furukawa, Yoshihito Masuoka, Misuzu Yamada, Taro Mashiko, Takuma Tajiri, Toshio Nakagohri, Hiroyasu Makuuchi
KEYWORDS:
Early Detection, Recurrence Factor, Small Pancreatic Carcinoma
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.8 No.12,
December
12,
2017
ABSTRACT: Background: Pancreatic carcinoma has a poor prognosis. It is important to focus on
early detection and treatment for improvement of the prognosis. Understanding
the characteristics of TS1 pancreatic carcinoma (≤2 cm) could improve the
treatment outcome of pancreatic carcinoma. Methods: Among 444 patients
with conventional pancreatic carcinoma who underwent surgery at our facility,
the study targeted 65 (14.6%) with a histopathological diagnosis of TS1
pancreatic carcinoma. We examined 65 cases of TS1 pancreatic carcinoma in
reason for hospital visit, examination findings, histopathological findings,
and treatment outcomes. Results: The detection rate of TS1 pancreatic
carcinoma by ultrasonography was 83.1% for visualization of the tumor mass and
96.9% for main pancreatic duct dilatation. The corresponding rates for
endoscopic ultrasound were 92.9% and 100%. With regard to postoperative
outcome, 43.1% of patients had a recurrence; the site of recurrence was local in
24.6% and hepatic in 9.2%. On multivariate analysis, intrapancreatic neural
invasion was an independent risk factor for recurrence (odds ratio, 6.333; 95%
confidence interval, 1.834 - 21.872; p = 0.004). Conclusions: To screen for TS1
pancreatic carcinoma, the study first examined for main pancreatic duct
dilatation by ultrasonography and then conducted a detailed examination with endoscopic
ultrasound. Patients with pancreatic neural invasion require careful attention
for local recurrence.