RELIABILITY OF PANCREATIC-CANCER STAGING CLASSIFICATIONS

The prognostic value of UICC and JPS classifications was evaluated in a group of 74 patients undergoing resection for pancreatic carcinoma i n the 1982-1992 period. The predictivity of peritoneal cytology and in traoperative liver biopsies was evaluated in a subgroup of 15 patients . Patient division by stage according, respectively, to UICC and JPS c lassifications was: stage I: 28 and 2 patients; stage II: 12 and 11 pa tients; stage III: 29 and 30 patients; stage IV: 5 and 31 patients. Me dian survival by UICC stages was: 17 months (m) in stage I, 10 m in st age II, 12 m in stage III, and 6 m in stage IV; by JPS stages it was 2 9 m in stage II, 14 m in stage III, and 7 m in stage IV. A radical res ection was possible in 48 patients (65%); the survival was significant ly worse in the nonradical resection group. The survival difference am ong UICC stages was not significant in a multivariate analysis with ra dicality, whereas among JPS stages a significant survival difference w as found in both univariate and multivariate analysis. The tumor invas ion of the retroperitoneal tissues and the presence of distant metasta sis were indicators of a significantly worse prognosis. Lymph node inv olvement, tumor size, and serosal invasion had no significant effect o n survival. Peritoneal cytology and liver biopsies did not provide fur ther prognostic information.