Twenty-three pancreatectomized cases for pancreatic cancer of duct cell origin were divided into solid type (16 cases) and cystic type (7) by macroscipic tumor form, and clinicopathological studies were done.
Solid tumors, being tubular adenocarcinomas, showed remarkable infiltrative growth with venous, neural and lymphatic invasions, which necessitated the cut margin of the pancreas to be at least 3 cm distant from macroscopic edge of the tumor. Histological invasion to retropancreatic tissues and regional lymph node involvement were widely observed. Sufficinet dissection of retropancreatic tussues including the extrapancreatic nervous plexus, wide dissection of regional lymph nodes including para-aortic and/or large vascular resection such as portal vein should be performed. On the other hand, cystic tumors, being intraductal papillary carcinomas, cystadenocarcinomas or mucinous adenocarcinomas, showed expansive but non-invasive character.
Postoperative results were poor in solid tumors, and the prognosis was markedly influenced by invasive characters, especially invasions of the intrapancreatic vein and retropancreas including surgical margin. On the contrary, the results were extremely good in cystic tumors. This difference may lie in factors v and rp. Factor ew is a prognosis-regulating factor in macrosopic curative resections for solid tumors.