[Prognostic factors in pancreatic cancer].

In the consideration of prognostic factors, periampullary carcinoma must be differentiated from pancreatic carcinoma. With periampullary carcinoma the classic (postoperative) prognostic parameters (tumor diameter, lymph node status, UICC-stage and residual tumor), prove to be reliable, however in pancreas carcinoma these parameters have very little if any prognostic value. Morphologic biological parameters such as ploidy, proliferation rate, growth factors, etc. are indeed showing some interesting preliminary findings, but so far have yielded no results which are prognostically relevant. This altogether sobering situation can really be attributed to the very different degrees of effectiveness of radical surgery for periampullary and particularly pancreatic carcinoma. The development of sensitive methods for early tumor diagnosis and for (molecular genetic) assessment of individual tumor risk can contribute to the improvement of this situation.