title: Survival among pancreaticoduodenectomy patients treated for pancreatic head cancer <1 or 2 cm.
abstract: BACKGROUND
  Size of primary tumor has implications for staging, imaging, and treatment of pancreatic head carcinomas. Limited data suggest that small tumor size is associated with better survival. The objective of this population study is to analyze characteristics and survival of patients with resected pancreatic head ductal carcinomas sized <1 and 2 cm.
  
  
  METHODS
  Analysis of resected invasive pancreatic head ductal carcinomas captured within SEER Program from 1998 to 2008.
  
  
  RESULTS
  A total of 7,135 cases were analyzed with nodal metastases in 31, 55, and 67 % for subcentimeter, 1.1-2 cm, and >2 cm tumors, respectively. Median survival was longest for node-negative tumors (38, 26, 19 months for tumors measuring ≤ 1, 1.1-2, and >2 cm, respectively; p < 0.001) versus node-positive tumors (18, 19, 14 months, p < 0.001). In multivariate analysis, large tumor size was associated with higher risk of death (hazard ratio (HR) = 1.179 for tumors 1.1-2 cm, p = 0.152; HR = 1.665 for tumors >2 cm, p < 0.001).
  
  
  CONCLUSIONS
  Small pancreatic cancers have a poor prognosis and surprisingly high rate of nodal involvement; therefore, they cannot be considered early cancers. Size-based screening is unlikely to save lives with current treatment options.
authors.affiliation: Mercy Medical Center, Des Moines, IA, USA. jan.franko@gmail.com
authors.forename: Jan
authors.initials: J
authors.lastname: Franko
authors.forename: Vladimir
authors.initials: V
authors.lastname: Hugec
authors.forename: Tercio L
authors.initials: TL
authors.lastname: Lopes
authors.forename: Charles D
authors.initials: CD
authors.lastname: Goldman
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000401:mortality*; D011379:Prognosis; D015996:Survival Rate