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Treatment decision making in pancreatic adenocarcinoma: multidisciplinary team discussion with multidetector-row computed tomography.

Furukawa H, Uesaka K, Boku N

Division of Diagnostic Radiology, Shizuoka Cancer Center Hospital, Shizuoka, Japan.

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.

Published 18 March 2008 in Arch Surg, 143(3): 275-80; discussion 281.
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