Purpose
Pancreatic adenocarcinoma remains the fourth leading cause of cancer related death
and is one of the most aggressive malignant tumors with an overall 5-year survival rate of
less than 4% . It is characterized by rapid local growth, frequent invasion of surrounding
structures, and the early creation of distant metastases [1,2].
Surgical resection represents the only potentially curative treatment, but it is only possible
for 15-20% of patients with pancreatic carcinoma. About 40% of patients have locally
advanced, nonresectable disease. The remaining patients have metastatic disease.
Consequently, approximately 80-85% of patients are treated palliatively or neoadjuvantly
[3]. Therefore accurate staging is essential to differentiate the resectable patients from
the unresectable and imaging plays the critical role in making this differentiation.
Multi-detector computed tomography (MDCT) has been widely accepted as the imaging
technique of choice for diagnosing and staging of pancreatic cancer [4]. In the absence
of metastatic disease, which would preclude resection, assessment of vascular invasion
is an important parameter for determining resectability of pancreatic cancer. Current
imaging modalities have improved and allow detection of vascular invasion with more
accuracy. With advances in surgical techniques, and preoperative management vascular
resection and reconstruction are increasingly performed, patients thought previously to
be unresectable are undergoing radical surgery.
The results of CT help surgeons to evaluate the operability, surgical difficulty,
and prognosis, but sometimes incorrect predictions results in inappropriate therapy.
Obviously, surgical exploration with pathological examination remains the «gold standard»
in terms of evaluation of resectability, especially from the point of view of vascular
involvement [5].
The purpose of our study was to retrospectively evaluate the ability of multi-detector
computed tomography in staging and predicting resectability of pancreatic cancer and
to determine how reliable are MDCT criteria of pancreatic carcinoma resectability in
correlation with surgical and morphological results.
