Document Detail

Is there a role for staging laparoscopy in patients with locally advanced, unresectable pancreatic adenocarcinoma?
MedLine Citation:
PMID:  15585395     Owner:  NLM     Status:  MEDLINE    
The study objective was to determine the incidence of laparoscopically detected metastasis in patients with radiographically staged locally advanced adenocarcinoma of the pancreas. Patients with locally advanced pancreatic cancer are considered candidates for novel treatment protocols. Stratification of patients into locally advanced disease versus metastatic disease is imperative to accurately evaluate treatment outcome. Between 1994 and 2000, 100 consecutive patients undergoing staging laparoscopy with radiologic evidence of unresectable locally advanced pancreatic cancer were identified from a prospective database. All patients had preoperative contrast-enhanced, thin-cut computed tomography scanning or magnetic resonance imaging and had no evidence of detectable metastatic disease. There were 53 men and 47 women, with a median age of 64 years. The disease site was the pancreatic head in 69 cases and the body or tail in 31. Radiographic assessment of nonresectability was due to encasement of the celiac or hepatic artery in 37 patients, of the portal vein and superior mesenteric vessels in 56, and extrapancreatic extension in 7. Laparoscopy identified metastatic disease in 37% of patients, not seen on preoperative imaging. Peritoneal disease was noted in 12 cases and liver metastasis in 18 cases, and 7 patients had both. Neither the primary tumor size nor location influenced the incidence of metastatic disease. Standard imaging modalities failed to detect metastatic disease in 37% of patients who were considered to have locally advanced pancreatic cancer. Patients considered for treatment protocols for locally unresectable pancreatic cancer should be staged laparoscopically before initiation of therapy.
Margo Shoup; Corinne Winston; Murray F Brennan; Diane Bassman; Kevin C Conlon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  8     ISSN:  1091-255X     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-12-08     Completed Date:  2005-05-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1068-71     Citation Subset:  IM    
From the Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
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MeSH Terms
Adenocarcinoma / pathology*,  secondary,  surgery
Databases, Factual
Liver Neoplasms / secondary
Magnetic Resonance Imaging
Middle Aged
Neoplasm Metastasis
Neoplasm Staging
Pancreatic Neoplasms / pathology*,  surgery
Peritoneal Neoplasms / secondary
Prospective Studies
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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