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Characterization of Tumors of the Pancreas and the Pancreatoduodenal Area in own Material, in 2-Year Prospective Observation

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Cichocki A., Jóźwiak M., Samsel R., Piotrowski P., Nawrocki G., Roszkowska K.
Polish Journal of Surgery
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2008
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vol. 80
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issue 5
233-240
EN
Tumors of the pancreas and the pancreatoduodenal area constitute a group characterized by highly variable histological structure and differing prognosis. Adenocarcinoma of the pancreas is the most common tumor of this area and prognosis of patients with this tumor still remains poor.The aim of the study was to present characteristics of tumors of the pancreatoduodenal are and the pancreas in our own material.Material and methods. Since May 2005, a systematic prospective assessment was started of patients with tumors of the pancreas that underwent surgery in Department of Surgery, Clinic of Oncology, Center of Oncology in Warsaw. Within 22 months, between 1.03.2005 and 31.12.2006, 85 patients (42 women, 43 men) with lesions of the pancreas or ampulla of Vater, potentially amenable to resection, were qualified for surgical treatment. An average age of patients that underwent surgery was 61.2 years.Results. Surgical resection was performed in 43 patients (50.6%), including: 17 pancreatoduodenectomies (39.5%), 7 total pancreatectomies (16.3%), 16 peripheral splenopancreatectomies (37.2%) and 3 local resections/lesion extirpation (7%).The most common reasons for refraining from resection included: involvement of mesenteric vessels (12/42 - 28.6%), infiltration of portal vein system (19%), liver metastases (19%).Adenocarcinoma of the pancreas was the predominant histological diagnosis (32/85 - 37.64%), followed by chronic pancreatitis (14.1%). Tumors of uncertain or unknown malignant potential (neuroendocrine tumors, mucinous cystic neoplasm, solid cystic papillary tumor) were diagnosed in 13 patients (15.3%).Conclusions. Despite more and more precise preoperative diagnosis, significant percentage of patients qualified for radical resection of tumors of the pancreas and pancreatoduodenal area, have lesions not amenable to surgical resection. Significant percentage of tumors of uncertain or unknown malignant potential in the presented material must be emphasized. This group of patients requires different management approach than patients with adenocarcinoma.
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