title: Carcinoma of the pancreas and papilla of Vater: presenting symptoms, signs, and diagnosis related to stage and tumour site. A prospective multicentre trial in 472 patients. Norwegian Pancreatic Cancer Trial.
abstract: During the period 1984-87, 472 patients with histologically or cytologically verified carcinoma of the pancreas (n = 442) or the papilla of Vater (n = 30) were accrued. Diagnostic investigations were performed in accordance with the ordinary routines of 38 Norwegian hospitals. Jaundice at presentation, found in 47% of the patients, indicated a relatively low staging. Abdominal pain or weight loss, present in 72% and 58%, respectively, indicated higher staging. The sensitivities of the diagnostic investigations were 1) endoscopic retrograde cholangiopancreatography (ERCP), 79%, and computed tomography (CT), 75%; 2) ultrasonography (US), 57%; angiography performed in 18% to assess unresectability, sensitivity, 43%; fine-needle aspiration cytology performed in 27%, sensitivity, 86%; and percutaneous transhepatic cholangiography (PTC) performed solely on papillar and head tumours in 16%, sensitivity, 85%. In stage I, PTC and ERCP had a sensitivity of 78%; CT, 52%; and US, 40%. Patient's, physician's, and diagnostic delay averaged 1.8, 2.4, and 4.0 months, respectively. The delays were shortest in stage I and papillar carcinomas.
authors.affiliation: Dept. of Surgery, Haukeland University Hospital, Norway.
authors.forename: K E
authors.initials: KE
authors.lastname: Bakkevold
authors.forename: B
authors.initials: B
authors.lastname: Arnesjø
authors.forename: B
authors.initials: B
authors.lastname: Kambestad
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000453:epidemiology; D000368:Aged; D014670:Ampulla of Vater; D003138:Common Bile Duct Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D008297:Male; D009664:Norway / Q000453:epidemiology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D011446:Prospective Studies; D012680:Sensitivity and Specificity