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Treatment Decision Making in Pancreatic AdenocarcinomaMultidisciplinary Team Discussion With Multidetector-Row Computed Tomography
Hiroyoshi Furukawa, MD, PhD;
Katsuhiko Uesaka, MD, PhD;
Narikazu Boku, MD, PhD
Arch Surg. 2008;143(3):275-280.
Hypothesis Multidetector-row computed tomography reduces the frequency of use of other imaging methods in patients with pancreatic carcinoma.
Design Validation cohort study.
Setting Tertiary care public hospital.
Patients Two hundred thirteen patients with pancreatic carcinoma.
Main Outcome Measure Multidetector-row computed tomography was initially performed in patients with newly diagnosed pancreatic carcinoma.
Results Of the 213 pancreatic carcinomas, 79 (37%) were classified as probably resectable, 127 (60%) as certainly unresectable, and 7 (3%) as probably unresectable. Of 79 tumors classified as probably resectable, 68 (86%) were found to be resectable, 7 tumors considered as probably unresectable were unresectable, and the remaining 127 tumors were treated nonsurgically. Magnetic resonance imaging was recommended in 92 patients (43%), angiography in 1 patient (0.5%), and both endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in 15 patients (7%).
Conclusions Multidetector-row computed tomography provides reliable information for staging pancreatic carcinoma. Multidisciplinary team discussion along with use of this noninvasive technique simplifies the diagnostic strategy for pancreatic carcinoma and decreases the need for invasive staging methods.
Author Affiliations: Divisions of Diagnostic Radiology (Dr Furukawa), Hepato-Biliary-Pancreatic Surgery (Dr Uesaka), and Gastroenterology and Endoscopy (Dr Boku), Shizuoka Cancer Center Hospital, Shizuoka, Japan.
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Treatment Decision Making in Pancreatic Adenocarcinoma—Invited Critique
David B. Adams
Arch Surg. 2008;143(3):281.
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