Type:
Educational Exhibit
Keywords:
Abdomen, Pancreas, Oncology, CT, Neoplasia
Authors:
C. Caraiani1, A. Lebovici2, O. S. M. Isse2; 1Cluj-Napola/RO, 2Cluj-Napoca/RO
DOI:
10.1594/ecr2011/C-2001
Background
Pancreatic carcinoma is a tumor with very poor prognosis.
Surgery is the only curative technique in pancreatic carcinoma.
Unfortunately,
at the moment of the diagnosis,
most of the tumors are unavailable for curative surgery.
Pancreatic surgery is a tehnique with a high mortality and morbidity.
Zamboni and co appreciate,
in a 2007 paper,
mortality of the procedure at 5% and morbidity at 40%.
In our series mortality is a little bit higher- 10% and morbidity is comparable-40%.
The radiologist has to answer the question which patiens are available for pancreatic surgery and which are not.
If we clasify operable tumors as unoperable (false positive result of unoperable tumor) we refuse the only chance for curative treatment to some patients.
If we clasify unoperable tumors as operable (false negative result of unoperable tumor) we expose patients to a high-risk surgical procedure.
The CT criteria for unresecability are hepatic metastases,
peritoneal carcinomatosis,
lymphatic metastases (except the peripancreatic ones),
invasion of other organs (excepting the duodenum) and vascular invasion.