Assessment of resectability of pancreatic cancer by ultrasonography and computed tomography

BACKGROUND: Surgical resection is the only curative treatment of pancreatic carcinoma (PC). An accurate assessment of the extension of PC is mandatory to select appropriate patients to this therapeutic option. This study was aimed at assessing the usefulness of abdominal ultrasonography (US) and com puted tomography (CT) to establish tumoral staging and to predict tumor res ectability. PATIENTS AND METHODS: Between January 1990 and December 1995, 84 PC patient s were submitted to surgical procedures (potentially curative resection in 30%, biliodigestive anastomosis in 51% and exploratory laparotomy in 13%). Preoperative staging was carried out by means of abdominal US and/or CT. De finitive staging was established according to surgical findings, using the TNM classification. RESULTS: Accuracy Of preoperative evaluation with regard to tumoral staging was 65%, being underestimated in 29 (35%) patients. This underestimation w as mainly due to lesions in stage I. In addition, preoperative staging pred icted tumor unresectability with a 50% sensitivity and a 83% specificity. CONCLUSIONS: US and CT have a good specificity in the staging and unresecta bility prediction of pancreatic cancer. However, their usefulness is limite d by their low sensitivity.