Is tumour size an underestimated feature in the current TNM system for malignancies of the pancreatic head?

Details

Serval ID
serval:BIB_DD8EB9FE3493
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Is tumour size an underestimated feature in the current TNM system for malignancies of the pancreatic head?
Journal
Hpb
Author(s)
Petermann D., Demartines N., Schäfer M.
ISSN
1477-2574 (Electronic)
ISSN-L
1365-182X
Publication state
Published
Issued date
2013
Peer-reviewed
Oui
Volume
15
Number
11
Pages
872-881
Language
english
Notes
Publication types: ARTICLE
Abstract
BACKGROUND: As the long-term survival of pancreatic head malignancies remains dismal, efforts have been made for a better patient selection and a tailored treatment. Tumour size could also be used for patient stratification. METHODS: One hundred and fourteen patients underwent a pancreaticoduodenectomy for pancreatic adenocarcinoma, peri-ampullary and biliary cancer stratified according to: ≤20 mm, 21-34 mm, 35-45 mm and >45 mm tumour size. RESULTS: Patients with tumour sizes of ≤20 mm had a N1 rate of 41% and a R1/2 rate of 7%. The median survival was 3.4 years. N1 and R1/2 rates increased to 84% and 31% for tumour sizes of 21-34 mm (P = 0.0002 for N, P = 0.02 for R). The median survival decreased to 1.6 years (P = 0.0003). A further increase in tumour size of 35-45 mm revealed a further increase of N1 and R1/2 rates of 93% (P < 0.0001) and 33%, respectively. The median survival was 1.2 years (P = 0.004). Tumour sizes >45 mm were related to a further decreased median survival of 1.1 years (P = 0.2), whereas N1 and R1/2 rates were 87% and 20%, respectively. DISCUSSION: Tumour size is an important feature of pancreatic head malignancies. A tumour diameter of 20 mm seems to be the cut-off above which an increased rate of incomplete resections and metastatic lymph nodes must be encountered and the median survival is reduced.
Pubmed
Web of science
Open Access
Yes
Create date
16/11/2013 15:35
Last modification date
20/08/2019 17:02
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