Abstract
This study was undertaken to verify whether new diagnostic tools (angiography, endoscopic retrograde cholangiopancreatography, ultrasonography, and computed tomography) have improved the detection of pancreatic cancer at a resectable stage. Two groups of patients with histologically ascertained cancer of the pancreas were examined. The first consisted of 54 cases investigated before the clinical application of the four abovementioned techniques and the second of 74 cases investigated thereafter. Cancer resectability was judged by a surgical team at the time of laparotomy according to preestablished criteria. No significant difference was found between the number of resections and other procedures in the two groups. On the other hand exploratory laparotomies performed exclusively for diagnostic purposes were significantly (P<0.01) reduced in the second group. On the basis of these results one may conclude that new diagnostic aids are useful and reliable in the preoperative detection of pancreatic cancer, but their introduction into clinical practice has not permitted an earlier diagnosis of the disease and therefore there has been no important increase in its resectability.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Gudjonsson B, Livstone EM, Spiro HM: Cancer of the pancreas. Diagnostic accuracy and survival statistics. Cancer 42:2494–2506, 1978
Mackie CR, Dhorajiwala J, Blackstone MD, Bowie J, Moossa AR: Value of new diagnostic aids in relation to the disease process in pancreatic cancer. Lancet 2: 385–388, 1979
Moossa AR, Lewis MH, Mackie CR: Surgical treatment of pancreatic cancer. Mayo Clin Proc 54:468–474, 1979
Longmire WP Jr, Traverso LW: The Whipple procedure and other standard operative approaches to pancreatic cancer. Cancer 47:1706–1711, 1981
Fortner JG: Surgical principles for pancreatic cancer: Regional total and subtotal pancreatomy. Cancer 47:1712–1718, 1981
Di Magno EP, Malagelada JR, Taylor WF, Go VLW: A prospective comparison of current diagnostic tests for pancreatic cancer. N Engl J Med 297:737–742, 1977
Fitzgerald PJ, Fortner JG, Watson RC, Schwartz MK, Sherlock P, Benna RS, Cubilla AL, Schottenfeld D, Miller D, Winawer SJ, Lightdale CJ, Leidner SD, Nisselbaum JS, Menendez-Botet CJ, Poleski MH: The value of diagnostic aids in, detecting pancreas cancer. Cancer 41:868–879, 1978
Suramo, I, Lehtola J, Leinonen A, Kairaluoma M: The detection accuracy of gray-scale ultrasonography compared with ERP and arteriography in the detection of pancreatic carcinoma. Scand J Gastroenterol 14:993–996, 1979
Mackie CR, Cooper MJ, Lewis MH, Moossa AR: Nomoperative differentiation between pancreatic cancer and chronic pancreatitis. Ann Surg 189:480–487, 1979
Suzuki T, Imamura M, Tamura K, Sumiyoshi A, Sakanashi S, Nishimura Y, Tobe T: Correlative evaluation of angiography and pancreatoductography in relation to surgery for cancer of the pancreas. Surgery 85:644–651, 1979
Moossa AR, Levin B: Collaborative studies in the diagnosis of pancreatic cancer. Semin Oncol 6:298–308, 1979
Savarino V, Mansi C, Macchia G, Picciotto A, Testa R, Dabove L, Celle G. Computed tomography in the diagnosis of pancreatic diseases. Ital J Gastroenterol 12:265–269, 1980
Savarino V, Mansi C, Macchia G, Biggi E, Testa R, Picciotto A, Celle G: Are computed tomography and ultrasonography complementary or competitive techniques in the diagnosis of pancreatic diseases? Acta Gastroenterol Beld 44:528–537, 1981
Tylén U, Arnesjö B: Resectability and prognosis of carcinoma of the pancreas evaluated by arteriography. Scand J Gastroenterol 8:691–697, 1973
Clouse ME, Gregg JA, Sedgwick CE: Angiography vs pancreatography in diagnosis of carcinoma of the pancreas. Radiology 114:606–610, 1975
Feinberg SB, Schreiber DR, Goodale R: Comparison of ultrasound pancreatic scanning and endoscopic retrograde cholangiopancreatograms: A retrospective study. J Clin Ultrasound 5:96–100, 1977
Husband JE, Meire HB, Kreel L: Comparison of ultrasound and computer-assisted tomography in pancreatic diagnosis. Br J Radiol 50:855–862, 1977
Freeny PC, Ball TJ: Evaluation of endoscopic retrograde cholangiopancreatography and angiography in the diagnosis of pancreatic carcinoma. Am J Roentgenol 130:683–691 1978
Malagelada JR: Pancreatic cancer. An overview of epidemiology, clinical presentation, and diagnosis. Mayo Clin Proc 54:459–467, 1979
Hancke S, Holm HH, Koch F: Ultrasonically guided percutaneous fine needle biopsy of the pancreas. Surg Gynecol Obstet 140:361–364, 1975
Yamanaka T, Kimura K: Differential diagnosis of pancreatic mass lesion with percutaneous fine-needle aspiration biopsy under ultrasonic guidance. Dig Dis Sci 24:694–699, 1979
Yeh HY: Percutaneous fine needle aspiration biopsy of intraabdominal lesions with ultrasound guidance. Am J Gastroenterol 75:148–152, 1981
Hovdenak N, Lees WR, Pereira J, Beilby JOW, Cotton PB: Ultrasound-guided percutaneous fine-needle aspiration cytology in pancreatic cancer. Br Med J 285:1183–1184, 1982
Go VLW, Taylor WF, Di Magno EP: Efforts at early diagnosis of pancreatic cancer: The Mayo Clinic experience. Cancer 47:1698–1703, 1981
Moossa AR, Levin B: The diagnosis of “early” pancreatic cancer: The University of Chicago experience. Cancer 47:1688–1697, 1981
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Savarino, V., Mansi, C., Bistolfi, L. et al. Failure of new diagnostic aids in improving detection of pancreatic cancer at a resectable stage. Digest Dis Sci 28, 1078–1082 (1983). https://doi.org/10.1007/BF01295805
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01295805