Management of locally advanced periampullary tumors: A multicenter study

Abstract

Background: Pancreas may develop either benign or malignant tumors. Pancreatic cancer (PC) is one of the most lethal solid tumors which ranking as the fourth cause of cancer-related death in the United States. Aim: To analyze the results of treatment of locally advanced pancreatic cancer to come up with management strategy. Patients and Methods: Patients (n=136) were retrospectively evaluated with periampullary carcinoma where 40 patients were diagnosed as locally advanced periampullary carcinoma, from January 2010 to January 2018 in multicenter. Results: Patients diagnosed as pancreatic head carcinoma in 20/40 and periampullary carcinoma in 20/40 of patients, all patients were diagnosed as locally advanced pancreatic cancer by radiological imaging, where 28/40 (70%) was males and 12/40 (30%) were females with male:female ratio of 2.3:1. The age of patients at diagnosis was 39-62 years with a median age of 51 years. All patientswere = evaluated and followed up for 24 months with Multislice CT, PET-CT and tumor markers. Some patients underwent neoadjuvant treatment for down staging and were then surgery was done for 25/40 cases. Whipple’s operation without VR in 17/25 and VR done in 8/25 cases, where 6/40 cases died during chemotherapy and 9/40 unfit for surgery due to disseminated disease and complications of chemotherapy. Conclusion: Pancreatic cancer patients diagnosed as locally advanced or metastatic tumor need MDT to decide different modes of treatment in order to obtain better results