title: Do patient- and tumor-related factors predict the peritoneal spread of pancreatic adenocarcinoma?
abstract: OBJECTIVE
  In pancreatic cancer, the presence of peritoneal carcinomatosis (PC) precludes the possibility of a surgical cure, irrespective of the resectability of the primary tumor. However, peritoneal spread cannot be reliably detected radiographically during preoperative tumor staging.
  
  
  METHODS
  The pancreatic adenocarcinoma database of the Tübingen Comprehensive Cancer Center included 29 patients in whom PC was incidentally detected during the surgery. These patients were retrospectively compared for patient- and tumor-related factors with 29 randomly selected patients without PC who underwent curative resection.
  
  
  RESULTS
  Clinical jaundice and diarrhea were more frequently present in patients without PC. The CA 19-9 levels were significantly higher in patients with PC compared to those in patients without PC. No other differences were observed in the patient- or tumor-related factors between the two groups.
  
  
  CONCLUSIONS
  In pancreatic cancer patients, markedly elevated CA 19-9 levels may serve as surrogate marker for peritoneal dissemination, irrespective of the local resectability of the tumor. In such patients, laparoscopy should be considered as an additional staging tool to rule out peritoneal carcinomatosis.
authors.affiliation: Department of General, Visceral and Transplant Surgery, University of Tübingen Comprehensive Cancer Center, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany, ingmar.koenigsrainer@med.uni-tuebingen.de.
authors.forename: Ingmar
authors.initials: I
authors.lastname: Königsrainer
authors.forename: Derek
authors.initials: D
authors.lastname: Zieker
authors.forename: Stephan
authors.initials: S
authors.lastname: Symons
authors.forename: Katharina
authors.initials: K
authors.lastname: Horlacher
authors.forename: Alfred
authors.initials: A
authors.lastname: Königsrainer
authors.forename: Stefan
authors.initials: S
authors.lastname: Beckert
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D018395:CA-19-9 Antigen / Q000097:blood; D005260:Female; D005544:Forecasting; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen