Early pancreatic ductal adenocarcinoma: Definition,diagnosis, and prognosis

Early pancreatic ductal adenocarcinomas may be defined as tumors limited to the duct epithelium without invasion to the parenchyma. The majority of these tumors are less than 1 cm in diameter. The patient's symptoms and laboratory studies provide only limited assistance in the screening of small pancreatic carcinomas. Ultrasound (US), because of its ease of use and accuracy, is best suited as a screening procedure for small pancreatic carcinomas. Computed tomography (CT) is also valuable for such screening. When US and CT findings suggest the presence of small pancreatic carcinomas, endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) should be employed; these latter two modalities can show very small tumors. Our follow up of patients with pancreatic ductal adeno-carcinoma in whom the tumor was resected showed that survial depended on tumor size. The postoperative 5-year cumulative survival rate of patients with tumors less than 1 cm in diameter was 100%.