Pancreatic cancer: unreliability of frozen section in diagnosis.
Thirty-two patients with a resectable mass in the head of the pancreas had pancreaticoduodenectomy for suspected or proven cancer. Twenty-eight proved to have cancer (15 periampullary and 13 pancreatic), and four had pancreatitis. The five-year survival for periampullary and pancreatic cancer was 25% and 0%, respectively. The operative mortality was 19%. There were no false-positive frozen section diagnoses. Seventy-five percent with negative frozen section proved to have cancer, of which 17% were five-year survivors. Surgical judgment based on clinical findings may be more reliable than a negative frozen section in the diagnosis of suspected malignancy. Pancreaticoduodenectomy can be done on the basis of clinical judgment when no tumor is seen on frozen section of a mass in the head of the pancreas.
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003937:Diagnosis, Differential; D004386:Duodenum / Q000473:pathology / Q000601:surgery; D005500:Follow-Up Studies; D005629:Frozen Sections; D006801:Humans; D007432:Intraoperative Period; D008867:Microtomy; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology / Q000601:surgery; D010183:Pancreatic Ducts / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D010195:Pancreatitis / Q000473:pathology; D011300:Preoperative Care