Find best premium and Free Joomla templates at GetJoomlaTemplatesFree.com

Franz tumour: Is a large resection always justified?

M. Campanile, A. Nicolas, S. Lebel, JM. Guys , P. de Lagausie

Pediatric Surgery Department, La Timone Children Hospital, Marseille, France

 

ABSTRACT 

Introduction: The solid and pseudo-papillary pancreatic tumours are rare and have a low malignant potential but sometimes they are locally very invasive. The most adequate treatment is complete resection of the tumour without fragmentation or laparoscopic approach. In front of a lesion that involve vital organs or vessels which cannot be sacrificed, it raises the question about the necessity of a mutilating excision, especially as this tumour seems to be a slow growing tumour. The aim of this study is to evaluate the risk underlying incomplete resection of these tumours.

Material and Methods: This is a retrospective study concerning all the publications (Pubmed) between 1985 and 2008 about incompletely resected Franz tumours (R1 microscopically incomplete resection or R2 macroscopically incomplete resection). The surgical teams that performed these incomplete resections were contacted for follow-up details of these patients.

Results: 14 authors were contacted (by email, mailing address and fax). By now 9 have responded; amongst these, 6 provided the data sought for, 2 are still checking their databases, one does not have access to the required data. 5 authors have not responded yet. Finally we have the follow-up of 10 patients (from 17 R1 and R2) who had incomplete resections: amongst them, 7 deceased between 12 and 324 months after surgery and 3 are alive, disease free 7 years after. The median survival rate of these patients is estimated at 84 months (7 years).

Discussion: Taking into account that these tumours develop especially in children and young women, a median survival rate of 7 years doesn’t seem to be an acceptable perspective.

Conclusion: In the setting of a pseudopapillary and solid pancreatic tumour with local invasion, a complete resection should always be performed, if possible, even with the price of a difficult and mutilating surgical intervention.

 

Key words: Franz tumour, incomplete resection, survival rate