|
KMID : 0870420080120030186
|
|
Korean Journal of Hepato-Biliary-Pancreatic Surgery
2008 Volume.12 No. 3 p.186 ~ p.190
|
|
|
Clinical Characteristics of Uncinate Process Carcinoma of the Pancreas
|
|
Kang Mee-Joo
Lee Kuhn-Uk
Lee Seung-Eun
Kim Sun-Whe
Hwang Dae-Wook
Lim Chang-Sup
Jang Jin-Young
|
|
|
Abstract
|
|
|
Purpose: The pancreatic uncinate process is defined as the portion of the pancreatic head that lies behind the SMV and SMA. In spite of its peculiar anatomical characteristics, there are few reports addressing the clinicopathologic features of uncinate process carcinoma (UPCa). The purpose of this study was to explore the clinical characteristics of UPCa and to compare them with the characteristics of carcinomas located in other parts of the pancreatic head (non- PCa).
Methods: We retrospectively reviewed the medical records of 380 patients (127 UPCa and 253 non-UPCa) treated for pancreatic head cancer at Seoul National University Hospital between January 2002 and December 2007. The patient demographics, clinical presentation, radiologic details, surgical data, and long-term survival rates were evaluated. The clinical characteristics were analyzed according to tumor location.
Results: Jaundice was less common in UPCa (56/127, 44.1% vs. 150/253, 59.3%; p=0.006). Duodenal obstruction (12/127, 9.4% vs. 11/253, 4.3%; p =0.049) and SMA invasion (56/127, 44.1% vs. 58/253, 23.0%; p<0.001) were more frequent in UPCa. Resectability (38/127, 30.0% vs. 117/253, 46.2%; p=0.002) and curative resection rate (29/127, 22.8% vs. 90/253, 35.6%; p=0.001) were significantly lower in UPCa. The overall 3-year survival rate (7.7% vs. 17.9%; p=0.019) and 3-year survival rate after curative resection (0% vs. 35.9%; p=0.012) were lower in UPCa.
Conclusion: UPCa less frequently caused jaundice, but more frequently caused duodenal obstruction. Frequent invasion into the SMA led to lower resectability and curative resection rates. Even in cases of R0 resection, long-term survival in the setting of UPCa was lower than that seen in the setting of non-UPCa, which suggests other unknown prognostic factors.
|
|
|
KEYWORD
|
|
|
Pancreas cancer, Head of the pancreas, Uncinate process
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
  
|
|