Progress in the diagnosis and treatment of pancreatic cancer--the Kyoto University experience.

In Japan the incidence and mortality of pancreatic cancer have increased in recent years. The mortality rates increase with age, reaching a peak in the 70 year bracket, and are higher in males than in females. Cigarette smoking and meat consumption may be causes of pancreatic cancer. Diagnosis of a small cancer is indispensable for detecting early cancer. Carcinoembryonic antigen (CEA) and CA 19-9 have not proved reliable markers for detecting a small cancer, although ultrasonography, computed tomography, endoscopic retrograde cholangiopancreatography and angiography have been useful diagnostic tools. As for the treatment of pancreatic cancer, potentially curative pancreatectomy with sufficiently wide free margins around the cancer is indispensable for curative treatment of patients with ductal cell adenocarcinoma of the pancreas. In patients with advanced pancreatic cancer with involvement of adjacent vessels and retroperitoneal invasion, combined pancreatectomy or bypass operation and radiotherapy improved the survival rate and proved of significant advantage for local control of pain and prognosis.