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Characteristics of Small Pancreatic Carcinoma: Neural Invasion is Associated with Tumor Recurrence

Journal of Cancer Therapy 2017年第12期8卷 1125-1134页

作者： Hideki Izumi Hisamichi Yoshii Masaya Mukai Eiji Nomura Naoki Yazawa Daisuke Furukawa Yoshihito Masuoka Misuzu Yamada Taro Mashiko Takuma Tajiri Toshio Nakagohri hiroyasu makuuchi Department of Gastrointestinal Surgery Tokai University Hachioji Hospital Tokyo Japan Department of Gastrointestinal Surgery School of Medicine Tokai University Kanagawa Japan Department of Pathology Tokai University Hachioji Hospital Tokyo Japan

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.

关键词： Early Detection Recurrence Factor Small Pancreatic Carcinoma

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