Surgical therapy of pancreatic carcinoma--indications and results

Primary malignant neoplasms of the pancreas can occur as ductal adenocarcinoma in up to 80% and as a carcinoma of the exocrine or endocrine parenchyma in up to 20%. The treatment of pancreatic cancer is tumor resection. The surgical procedure depends on the tumor site: subtotal pancreatectomy, total or partial duodenopancreatectomy (Whipple's operation). The morbidity ranges from 5 to 15% and the mortality from 2 to 10%. Pancreatic carcinoma has an extremely poor prognosis, the median survival ranges from three to six months, the 5-year survival rate is 2 to 8%. These results are caused by mostly advanced tumors at the time of diagnosis. Early tumor stages with a 5-year survival rate up to 40% account for only 10% of the resected tumors; therefore, after tumor resection, recurrent disease occurs in up to 90%.