[Surgical effect of malignant tumor of body and tail of the pancreas: compare with pancreatic head cancer].
OBJECTIVE
To investigate the clinical-pathological characteristics and surgical prognosis of malignant tumor of pancreatic body and tail.


METHODS
A retrospective study was accomplished on clinical manifestation, pathological behavior and postoperative survival in 106 patients with malignant tumor of pancreatic body and tail in single institution from Jan 1980 to Dec 2003, and compared these with 451 patients with malignant pancreatic cancer.


RESULTS
There were significant differences in the following parameters (malignant tumor of the body and tail vs those of the head) between the two tumors: (1) the complaints of pain (0.74:41, chi(2) = 37.035, P < 0.01) and jaundice (0.04:0.75, chi(2) = 155.509, P < 0.01); (2) serum SGPT [(27.33 +/- 3.98) U/L: (118.60 +/- 4.59) U/L, F = 89.351, P < 0.01], total bilirubin [(1.46 +/- 0.46) mg/dl: (14.11 +/- 0.60) mg/dl, F = 105.341, P < 0.01] and albumin [(4.20 +/- 0.45) g/L: (3.91 +/- 0.03) g/L, F = 26.642, P < 0.001]; (3) CEA (0.40:0.24, chi(2) = 6.148, P = 0.046) and CA-19-9 positive rate (0.57:0.86, chi(2) = 24.132, P < 0.01); (4) the concomitant total metastasis (0.38:0.20, chi(2) = 14.266, P < 0.01), including liver metastasis (0.30:0.17, chi(2) = 9.003, P < 0.01). Postoperative median survival, resection of non-metastatic pancreatic body and tail cancer was longer than resection of metastatic disease significantly (15 vs 7 months,chi(2) = 21.63, P < 0.01), which the latter was the same as those who didn't remove (6 months,chi(2) = 0.22, P = 0.64).


CONCLUSIONS
The predominant problem is distant metastasis (especially liver metastasis) in the malignant tumor of the body and tail of the pancreas in comparison with pancreatic head cancer. Resection of the body and tail could not increase postoperative survival if metastasis exists. The major way to improve the prognosis is to prevent and manage the distant metastasis.
Wu
Tie-cheng
TC
Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Science, Beijing 100021, China.
Shao
Yong-fu
YF
Shan
Yi
Y
Wu
Jian-xiong
JX
Zhao
Ping
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010179:Pancreas / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome