Gerken et al reported a model for predicting the resectability of a malignant tumor in the head of the pancreas. This can help guide patient management. The authors are from Hannover Medical School, University Medical Centre Schleswig-Holstein and Queen Elizabeth Hospital in Birmingham.
Patient selection: malignancy in the head of the pancreas
Parameters:
(1) resectability by CT scan
(2) probability of resectability by the prognostic model of Gerken et al
CT Scan
Probability of Resectability by Prognostic Model
Management
unresectable
NA
palliative care
resectable
>= 90% resectable
immediate surgery
resectable
< 90% resectable
additional evaluation to determine best strategy
Goals of the additional evaluation is to detect occult liver metastases, vascular invasion or peritoneal metastases.
Additional evaluation may include:
(1) PET-CT
(2) laparoscopic ultrasonography with endoscopic ultrasonography (EUS)
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