title: Back pain in patients with ductal pancreatic cancer. Its impact on resectability and prognosis after resection.
abstract: BACKGROUND
  Back pain is a frequent and often ominous clinical sign in patients with ductal pancreatic cancer.
  
  
  METHODS
  From 1971 to 1993 a pancreatic carcinoma could be resected in 192 patients, whereas 261 patients underwent either probatory laparotomy alone or palliative bypass procedures. In a retrospective study including uni- and multi-variate survival analysis we have determined the impact of preoperative back pain on both resectability and long-term prognosis after resection.
  
  
  RESULTS
  Among the presenting symptoms of patients with ductal pancreatic cancer back pain was a predictive sign of irresectability. In the presence of preoperative back pain the long-term prognosis after resection of the tumour was also significantly impaired. In a multivariate analysis it could be demonstrated that the prognostic impact of back pain was as strong as the influence of residual tumour, tumour grading, and tumour size.
  
  
  CONCLUSIONS
  Back pain often indicates irresectability of ductal pancreatic carcinoma and also impairs the long-term prognosis even after curative resection.
authors.affiliation: Clinic for Abdominal and Transplantation Surgery, Hannover Medical School, Germany.
authors.forename: G J
authors.initials: GJ
authors.lastname: Ridder
authors.forename: J
authors.initials: J
authors.lastname: Klempnauer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010166:Palliative Care; D010183:Pancreatic Ducts; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000401:mortality / Q000601:surgery; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis