Primary Article

Pancreatic Cancer: Unreliability of Frozen Section in Diagnosis

Authors: PHILIP L. HARRIS MD, THOMAS O. RUMLEY MD, WILLIAM C. LINEAWEAVER MD, EDWARD M. COPELAND III MD

Abstract

ABSTRACT: Thirty-two patients with a resectable mass in the head of the pancreas had pancreaticoduodenectomy for suspected or proven cancer. Twenty-eight proved to have cancer (15 periampullary and 13 pancreatic), and four had pancreatitis. The five-year survival for periampullary and pancreatic cancer was 25% and 0%, respectively. The operative mortality was 19%. There were no false-positive frozen section diagnoses. Seventy-five percent with negative frozen section proved to have cancer, of which 17% were five-year survivors. Surgical judgment based on clinical findings may be more reliable than a negative frozen section in the diagnosis of suspected malignancy. Pancreaticoduodenectomy can be done on the basis of clinical judgment when no tumor is seen on frozen section of a mass in! the head of the pancreas.

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