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[Clinicopathological studies on carcinoma of the pancreas with special reference to pathological factors affecting the prognosis and lymph node involvement].

A total of 63 cases of pancreatic carcinoma (52 cases of the head and 11 of the body and tail) which were resected for the past 12 and a half years were analyzed according to the General Rules for Surgical and Pathological Studies on Cancer of Pancreas issued by the Japanese Pancreatic Society. Carcinoma of the head of the pancreas The prognosis was remarkably influenced by the size of tumor (T), infiltrative growth (INF), lymphatic infiltration (ly), venous infiltration (v), perineural infiltration (ne), capsular infiltration (s) and histological lymph node involvement (n). Postoperative results were increasingly poor as these factors proceeded. Rate of lymph node metastasis was 75.0% and was influenced by anterior capsular invasion (S), ly, s and duodenal infiltration (du). The posterior and anterior portions of the head of the pancreas and the origin of SMA, in the order named, were the most common sites of lymph node metastasis. In pancreatic cancer, perineural infiltration was a characteristic finding in the surrounding tissue of the lymph nodes which occurred even in 25% of n0 cases. Carcinoma of the body and tail of the pancreas Rate of lymph node metastasis was 40%. The pattern of lymph node involvement was different from that of the carcinoma of the head of the pancreas, probably because that the lymph nodes were not so much metastasized as directly invaded by tumor.