STAGING AND EXTENDED RESECTION FOR PANCREATIC-CANCER

Extended surgery is being widely performed to treat pancreatic cancer in Japan, but it has not been evaluated in the same way as in other co untries. We, therefore, compared the Japanese Stage Classification (JP N-SC) with the Union Internationale Contre le Cancer Stage Classificat ion (UICC-SC) in the surgical cases of pancreatic cancer treated in ou r department and then assessed the results of extended resection and a ssociated problems. Problems existed in the resection rates and actuar ial survival rates in stages II and III in the UICC-SC, and the JPN-SC was found to reflect more accurately the outcome. On the other hand, although improvements in curative resection and actuarial survival rat e have been achieved as a result of extended resection in Japan, the o utcome in JPN-SC surgical stage IVb and highly advanced cases in which these resections proved to be noncurative even though they were class ified as surgical stage IVa was extremely poor. In the future, it will be necessary to decide on a single-stage classification that is accep ted throughout the world and to conduct prospective studies matched to the degree of tumor progression.