Surgical resection of pancreatic head cancer: What is the optimal extent of surgery?
BACKGROUND Differences in the clinical staging in Japan from that of the Union Internationale Contre le Cancer (UICC) staging system may account for discrepancies in the prognosis of carcinoma of the pancreas between Japan and the United States of America. STUDY DESIGN This study compares the usefulness of Japanese staging with the UICC staging in 1,689 patients who underwent resection for carcinoma of the pancreatic head registered with the Japan Pancreas Society. RESULTS The survival rate was correlated with the Japanese stage classification. The survival rate of patients with T4 tumors was surprisingly better than for those with T2 or T3 tumors. The extent of lymph node involvement and of extrapancreatic tissue invasion reflected the prognosis. The UICC staging system did not reflect differences in prognosis among the four stages, especially between stages II and III. CONCLUSIONS To establish a more practical and universal staging system for carcinoma of the pancreas, the Japanese system may offer improvements in predicting the prognosis of American or European patients with this disease.