BMJ 1994;308:1715 (25 June)

Letters

Surgery for pancreatic cancer

EDITOR, - It has been common practice, particularly in Britain, for patients with cancer of the pancreatic head and for some patients with periampullary cancer (which carries a much better prognosis) to be denied surgical assessment. Paul Ellis and David Cunningham rightly state that "patients with pancreatic cancer should not be denied the surgical option, and assessment by an experienced pancreatic surgeon is essential to achieve the best outcome."1 We wish to explain why, in the 1990s, surgical assessment is so important in patients with pancreatic tumours.

In the 1960s partial duodenopancreatectomy (Whipple's operation) was associated with a mortality of 30%. This led Crile and others to recommend that, for a disease that in the best hands gave a five year survival of 10%, patients should receive only palliative treatment.2 Since then mortality has dropped dramatically owing to better anaesthetic and surgical techniques. Cameron et al recently reported a 0% . . . [Full text of this article]


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Relevant Article

Current Issues in Cancer Management of carcinomas of the upper gastrointestinal tract
Paul Ellis and David Cunningham
BMJ 1994 308: 834-838. [Extract] [Full Text]

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