[Diagnosis and treatment of pancreatic carcinoma in the region of Amsterdam Comprehensive Cancer Care Center in 1997].
OBJECTIVE
To describe the diagnostic work-up and treatment of patients with a pancreatic carcinoma in the Amsterdam area, the Netherlands, particularly in general hospitals.


METHODS
Retrospective, descriptive.


METHODS
During 1997, 286 patients with a pancreatic carcinoma were diagnosed in 20 hospitals in the Amsterdam area. Diagnostic work-up and treatment data were collected from the medical records and analysed.


RESULTS
Ninety percent of the patients presented in one of the 17 general hospitals (n = 252; 132 men and 154 women; mean age: 70 years). Thirty-five percent of them underwent diagnostic investigations which did not focus directly on pancreatic pathology. Ultrasound was performed in 97% of patients (4% in combination with Doppler) and CT in 60% (4% spiral CT). Endoscopic retrograde cholangiopancreatography (ERCP) was performed in 39% of these patients and endoprostheses were only inserted in half the cases. Thirty-five percent of the patients who underwent both CT and ERCP underwent ERCP first. Ninety-nine patients (39%) were referred to a reference hospital for further investigation or treatment. The period between the first investigation and the histological diagnosis was 4 weeks.


CONCLUSIONS
In the diagnostic work-up of patients with a pancreatic carcinoma, invasive diagnostic procedures were often performed before the non-invasive tests. Spiral CT was used minimally and ERCP was frequently performed without subsequent biliary drainage. The mean duration of diagnostic work-up was relatively long.
Tilleman
E H
EH
Afd. Chirurgie, Academisch Medisch Centrum, Postbus 22660, 1100 DD Amsterdam.
Benraadt
J
J
Bossuyt
P M
PM
Obertop
H
H
Gouma
D J
DJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000706:statistics & numerical data; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D012042:Registries; D012189:Retrospective Studies; D015607:Stents / Q000706:statistics & numerical data; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data