Improved detection of cancer of the body or tail of the pancreas.

: Ultrasonography (US), computed axial tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP) have not improved detection or prognosis of carcinoma of the pancreatic head. We investigated the influence of these imaging techniques on detection, and consequently prognosis of carcinoma of the pancreatic body or tail, where the symptoms are less specific (seldom jaundice or vomiting) and imaging techniques may be more important. Of 139 patients, 29 were treated in 1972-1977, when US, CT and ERCP were not used, 27 in 1978-1980, when US was occasionally performed, and 83 in 1981-1989, when all three methods were common. In 1978-1980 and 1980-1981 correct ante-mortem diagnosis was more common than in 1972-1977, and the diameter and stage of tumour were significantly reduced at laparotomy. The resectability rate was not increased, however, and the incidence of exploratory laparotomy was not reduced. The survival time in the last study period was significantly longer only in the non-operatively treated patients. The reason was not earlier diagnosis, but possibly better general management.