#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Current review of the diagnosis and treatment of pancreatic cancer


Authors: F. Čečka 1;  B. Jon 1;  Z. Šubrt 1,2;  M. Kaška 1;  A. Ferko 1,2
Authors‘ workplace: Chirurgická klinika LF UK v Hradci Králové a FN, Hradec Králové Přednosta kliniky: prof. MUDr. Alexander Ferko, CSc. 1;  Katedra válečné chirurgie Fakulta vojenského zdravotnictví, Hradec Králové Univerzity obrany Brno Vedoucí katedry: doc. MUDr. Leo Klein, CSc. 2
Published in: Prakt. Lék. 2010; 90(10): 618-621
Category: Diagnostis

Overview

Pancreatic cancer has dismal prognosis. Its incidence in the Czech Republic is rising and it is currently the fourth most common cause of cancer related death. The most common presenting symptom is painless jaundice. Other symptoms include vomiting, epigastric pain, anorexia or diabetes mellitus. Diagnosis is based on imaging methods (ultrasound, CT, endosonography). The most significant tumor marker is CA 19-9, which is important both in the diagnostic process as well as in the follow-up. Surgical resection is the most significant treatment method and the only potentially curative method. Adjuvant and palliative chemotherapy improve quality of life and prolong patient survival. Locally advanced and disseminated disease has worse prognosis. The mean survival of patients with unresectable tumour is 6 to 10 months, mean survival after radical resection is 16 to 20 months. Therefore it is necessary to finish the diagnostic process and commence appropriate treatment in a specialized centre as soon as possible.

Key words:
pancreatic cancer, partial pancreaticoduodenectomy, jaundice, prognosis.


Sources

1. Šálek, C. Nové poznatky k epidemiologii nádorů pankreatu. Bull HPB 2004, 12, 3, s. 86-90.

2. Li, D., Morris, J.S., Liu, J. et al. Body mass index and risk, age of onset, and survival in patients with pancreatic cancer. JAMA 2009, 301, 24, p. 2553-2562.

3. Mulder, I., Van Genugten, M.L., Hoogenveen, R.T. et al. The impact of smoking on future pancreatic cancer: a computer simulation. Ann. Oncol. 1999, 10 Suppl 4, p. 74-78.

4. Lowenfels, A.B., Maisonneuve, P., Cavallini, G. et al. Pancreatitis and the risk of pancreatic cancer. International Pancreatitis Study Group. N. Engl. J. Med. 1993, 328, 20, p. 1433-1437.

5. Fisher, W. Diabetes: risk factor for the development of pancreatic cancer or manifestation of the disease? World J. Surg. 2001, 25, 4, p. 503-508.

6. Michaud, D.S., Giovannucci, E., Willett, W.C. et al. Physical activity, obesity, height, and the risk of pancreatic cancer. JAMA 2001, 286, 8, p. 921-929.

7. Hart, A.R., Kennedy, H., Harvey, I. Pancreatic cancer: a review of the evidence on causation. Clin. Gastroenterol. Hepatol. 2008, 6, 3, p. 275-282.

8. Schwartz, G., Reis, I. Is cadmium a cause of human pancreatic cancer? Cancer Epidemiol. Biomarkers Prev. 2000, 9, 2, p. 139-145.

9. Ghadirian, P., Liu, G., Gallinger, S. et al. A. Risk of pancreatic cancer among individuals with a family history of cancer of the pancreas. Int. J. Cancer 2002, 97, 6, p. 807-810.

10. Michaud, D.S., Giovannucci, E., Willett, W.C. Coffee and alcohol consumption and the risk of pancreatic cancer in two prospective United States cohorts. Cancer Epidemiol. Biomarkers Prev. 2001, 10, 5, p. 429-437.

11. Ye, W., Lagergren, J., Weiderpass, E. Alcohol abuse and the risk of pancreatic cancer. Gut 2002, 51, 2, p. 236-239.

12. Lillemoe, K.D., Yeo, C., Cameron, J.L. Pancreatic cancer: State-of-the-art care. CA Cancer J. Clin. 2000, 50, 4, p. 241-268.

13. Winter, J.M., Cameron, J.L., Lillemoe, K.D. et al. Periampullary and pancreatic incidentaloma: a single institution’s experience with an increasingly common diagnosis. Ann. Surg. 2006, 243, 5, p. 673-680.

14. Michl, P., Pauls, S., Gress, T.M. Evidence-based diagnosis and staging of pancreatic cancer. Best Pract. Res. Clin. Gastroenterol. 2006, 20, 2, p 227-251.

15. Zhao, W.Y., Luo, M., Sun, Y.W. et al. Computed tomography in diagnosing vascular invasion in pancreatic and periampullary cancers: a systematic review and meta-analysis. Hepatobiliary Pancreat. Dis. Int. 2009, 8, 5, p. 457-464.

16. Soriano, A., Castells, A., Ayuso, C. et al. Preoperative staging and tumor resectability assessment of pancreatic cancer: prospective study comparing endoscopic ultrasonography, helical computed tomography, magnetic resonance imaging, and angiography. Am. J. Gastroenterol. 2004, 99, 3, p. 492-501.

17. Farma, J.M.,Hoffman, J.P. Nonneoplastic celiac axis occlusion in patients undergoing pancreaticoduodenectomy. Am. J. Surg. 2007, 193, 3, p. 341-344.

18. Liao, Q., Zhao, Y.P., Yang, Y.C. et al. Combined detection of serum tumor markers for differential diagnosis of solid lesions located at the pancreatic head. Hepatobiliary Pancreat. Dis. Int. 2007, 6, 6, p. 641-645.

19. Zhang, S., Wang, Y. M., Sun, C. D. et al. Clinical value of serum CA19-9 levels in evaluating resectability of pancreatic carcinoma. World J. Gastroenterol. 2008, 14, 23, p. 3750-3753.

20. Tessler, D.A., Catanzaro, A., Velanovich, V. et al. Predictors of cancer in patients with suspected pancreatic malignancy without a tissue diagnosis. Am. J. Surg. 2006, 191, 2, p. 191-197.

21. Joseph, B., Morton, J.M., Hernandez-Boussard, T. et al. Relationship between hospital volume, system clinical resources, and mortality in pancreatic resection. J. Am. Coll. Surg. 2009, 208, 4, p. 520-527.

22. Sosa, J.A., Bowman, H.M., Gordon, T.A. et al. Importance of hospital volume in the overall management of pancreatic cancer. Ann. Surg. 1998, 228, 3, p. 429-438.

23. Yekebas, E.F., Bogoevski, D., Cataldegirmen, G. et al. En bloc vascular resection for locally advanced pancreatic malignancies infiltrating major blood vessels: perioperative outcome and long-term survival in 136 patients. Ann. Surg, 2008, 247, 2, p. 300-309.

24. Riall, T.S., Cameron, J.L., Lillemoe, K.D. et al. Pancreaticoduodenectomy with or without distal gastrectomy and extended retroperitoneal lymphadenectomy for periampullary adenocarcinoma—part 3: update on 5-year survival. J. Gastrointest. Surg. 2005, 9, 9, p. 1191-1204.

25. Traverso, L.W.,Longmire, W.P., Jr. Preservation of the pylorus in pancreaticoduodenectomy. Surg. Gynecol. Obstet. 1978, 146, 6, p. 959-962.

26. Diener, M.K., Knaebel, H.P., Heukaufer, C. A systematic review and meta-analysis of pylorus-preserving versus classical pancreaticoduodenectomy for surgical treatment of periampullary and pancreatic carcinoma. Ann. Surg. 2007, 245, 2, p. 187-200.

27. Kleeff, J., Diener, M.K., Z’graggen, K. et al. Distal pancreatectomy: risk factors for surgical failure in 302 consecutive cases. Ann. Surg. 2007, 245, 4, p. 573-582.

28. Sohn, T.A., Lillemoe, K.D., Cameron, J.L. et al. Surgical palliation of unresectable periampullary adenocarcinoma in the 1990s. J. Am. Coll. Surg. 1999, 188, 6, s. 658-666.

29. Andtbacka, R.H., Evans, D.B., Pisters, P.W. Surgical and endoscopic palliation for pancreatic cancer. Minerva Chir. 2004, 59, 2, p. 123-136.

30. Bradley, E.L., Bem, J. Nerve blocks and neuroablative surgery for chronic pancreatitis. World J. Surg. 2003, 27, 11, p. 1241-1248.

31. Smith, A.C., Dowsett, J.F., Russell, R.C. et al. Randomised trial of endoscopic stenting versus surgical bypass in malignant low bile duct obstruction. Lancet 1994, 344, 8938, p. 1655-1660.

32. Köninger, J., Moritz, N., Wente, M.N. et al. Surgical palliation in patients with pancreatic cancer. Langenbecks Arch. Surg. 2007, 392, 1, p. 13-21.

33. Gaidos, J., Draganov, P. Treatment of malignant gastric outlet obstruction with endoscopically placed self-expandable metal stents. World J. Gastroenterol. 2009, 15, 35, p. 4365-4371.

34. Shah, A.P., Strauss, J.B., Abrams, R.A. Review and commentary on the role of radiation therapy in the adjuvant management of pancreatic cancer. Am. J. Clin. Oncol. 2010, 33, 1, p. 101-106.

35. Rudloff, U., Maker, A. V., Brennan, M.F., Allen, P.J. Randomized clinical trials in pancreatic adenocarcinoma. Surg. Oncol. Clin. N. Am. 2010, 19, 1, p. 115-150.

36. Neoptolemos, J., Stocken, D.D., Friess, H. et al. A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer. N. Engl. J. Med. 2004, 350, 12, p. 1200-1210.

37. Regine, W.F., Winter, K., Abrams, R.A. et al. Fluorouracil vs gemcitabine chemotherapy before and after fluorouracil-based chemoradiation following resection of pancreatic adenocarcinoma: a randomized controlled trial. JAMA 2008, 299, 9, p. 1019-1026.

38. Oettle, H., Post, S., Neuhaus, P. et al. Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative-intent resection of pancreatic cancer: a randomized controlled trial. JAMA 2007, 297, 3, p. 267-277.

39. Duffy, A., Kummar, S. Metastatic pancreatic adenocarcinoma: current standards, future directions. Am. J. Ther. 2010, 17, 1, s. 79-85.

40. Gillen, S., Schuster, T., Meyer zum Büschenfelde, C. et al. Preoperative/neoadjuvant therapy in pancreatic cancer: A systematic review and meta-analysis of response and resection percentages. PLoS Medicine 2010, 7, 4, p. 267.

41. Morganti, A., Massaccesi, M., La Torre, G. et al. A systematic review of resectability and survival after concurrent chemoradiation in primarily unresectable pancreatic cancer. Ann. Surg. Oncol. 2010, 17, 1, p. 194-205.

42. Yeo, C., Cameron, J.L., Lillemoe, K.D. et al. Pancreaticoduodenectomy with or without distal gastrectomy and extended retroperitoneal lymphadenectomy for periampullary adenocarcinoma, part 2. Ann. Surg. 2002, 236, 3, p. 355-368.

43. Yeo, C.J., Cameron, J.L., Sohn, T.A. et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. Ann. Surg. 1997, 226, 3, p. 248-257.

Labels
General practitioner for children and adolescents General practitioner for adults
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#