[Carcinoma of the pancreas head, papilla Vateri, and cystadenocarcinoma--different biologic entities and different results].

Between 1986-1995 we operated 337 patients with ductal adenocarcinoma of the pancreas, 45 cases of carcinoma of the papilla of Vater and 11 patients with cystadenocarcinoma of the pancreas. The evaluation of prognostic factors showed the influence of lymph node invasion. Furthermore we saw a significant influence of lymph- and haemangiosis carcinomatosa, of tumor-grading and tumor-size. The carcinoma of the papilla showed a better 5-year survival even in nodal-positive patients--this as a result of a different biological behaviour. We think that--instead of missing improvement of cure in ductal adenocarcinoma over the past decade--there is no place for therapeutic nihilism especially in non-ductal cancer, which represents almost 15 % of all pancreatic neoplasms.