Improved survival in small pancreatic cancer

Background: Although the incidence of pancreatic cancer is relatively low compared with other tumors (2.4%), the death rate is high. Tumor detection and treatment at an early stage is necessary to improve the poor prognosis of patients, as is demonstrated by some reports showing a 5-year survival rate varying between 19 and 41% for patients undergoing radical pancreatectomy with the highest survival in patients with small tumors. Methods: In our study we retrospectively reviewed the histologic and demographic data of 596 patients who were admitted to the surgical units of the Careggi Hospital (University of Florence-AOC of Florence) between 1988 and 1994 with the incoming diagnosis of pancreatic cancer. Results: Results are reported as the mean B standard deviation. The postoperative survival rate was calculated by the Kaplan-Meier method and statistical analysis was performed by the log rank test (significance p ! 0.05). 247 patients had surgery, 110 with a curative intent. Postoperative mortality was 5.45%. The crude 5-year survival rate for patients who underwent curative surgery was 16.36% (18 patients), but for patients with small lesions confined to the pancreas (T1N0M0, 29 patients) this was even 31.03% (9 patients; p ! 0.01, ¯2 test). Conclusions: Our results indicate that it seems reasonable to consider these cancers as ‘small’, with survival eported in literature from 35 to 41%, so they probably represent the only curable condition at the present time.