Abdominal pain in patients with resectable pancreatic cancer with reference to clinicopathologic findings

Abdominal and/or back pain is one of the most common symptoms in patients w ith pancreatic cancer. However, the cause of the pain and the clinicopathol ogic features of patients with pain have not been fully elucidated. We retr ospectively determined the factors related to preoperative abdominal and/or back pain in 95 patients with resectable pancreatic cancer. Pancreatic tum or size, invasion of the intrapancreatic nerves, invasion of the anterior p ancreatic capsule, and lymph node metastasis were determined to be variable s related to the pain. Pancreatic tumor size, invasion of anterior pancreat ic capsule, and lymph node metastasis were also variables significantly cor relating to pain intensity. Survival also correlated with pain intensity: t he median survival periods were 29 months in patients without pain, 19 mont hs in those with mild pain, and 9 months in those with severe pain who requ ired analgesics. Larger pancreatic tumors, invasion of the intrapancreatic nerves, and invasion of the anterior pancreatic capsule may cause abdominal and/or back pain in patients with resectable pancreatic cancer. This study also suggests clinical implications of the pain intensity as a prognostic factor in patients with resectable pancreatic cancer.