Pancreatic Cancer--low Survival Rates

Overview

Journal Dtsch Arztebl Int

Specialties General Medicine
Public Health

Date 2009 Jul 25

PMID 19629206

Citations 13

Authors

Hans G Beger

Bettina Rau

Frank Gansauge

Gerd Leder

Michael Schwarz

Bertram Poch

Affiliations

Soon will be listed here.

Abstract

Introduction: Cancers of the pancreas are identified in 11 800 to 13 500 patients each year in Germany. Epidemiological studies prove smoking and chronic alcohol consumption as causes of about 30% of pancreatic cancers.

Methods: Selective literature review.

Results: Only patients within TNM stage I and II have after oncologic tumor extirpation a chance for long term survival. Controlled prospective clinical trials demonstrated adjuvant chemotherapy yielding an additional significant survival benefit. The 3- and 5-year-survival after R0-resection and adjuvant chemotherapy are about 30% and below 15% respectively. Using the criteria of observed 5-year-survival less than 2% of all pancreatic cancer patients are alive. After R0-resection the median survival time is between 17 and 28 months, after R1/2-resection between 8 and 22 months.

Discussion: Pancreatic cancer is even today for more than 95% of the patients incurable. Strategies to prevent pancreatic cancer are intended to stop smoking and chronic alcohol consumption and early surgical extirpation of cystic neoplastic lesions. For patients with established pancreatic cancer risk a follow-up protocol is discussed.

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References

Inoue S, Nakao A, Kasai Y, Harada A, Nonami T, Takagi H . Detection of hepatic micrometastasis in pancreatic adenocarcinoma patients by two-stage polymerase chain reaction/restriction fragment length polymorphism analysis. Jpn J Cancer Res. 1995; 86(7):626-30. PMC: 5920886. DOI: 10.1111/j.1349-7006.1995.tb02444.x. View

Su D, Yamaguchi K, Tanaka M . The characteristics of disseminated tumor cells in pancreatic cancer: a black box needs to be explored. Pancreatology. 2005; 5(4-5):316-24. DOI: 10.1159/000086532. View

Brown H, Ahrendt S, Komorowski R, Doffek K, Wilson S, Demeure M . Immunohistochemistry and molecular detection of nodal micrometastases in pancreatic cancer. J Surg Res. 2001; 95(2):141-6. DOI: 10.1006/jsre.2000.6026. View

Pedrazzoli S, Dicarlo V, Dionigi R, Mosca F, Pederzoli P, Pasquali C . Standard versus extended lymphadenectomy associated with pancreatoduodenectomy in the surgical treatment of adenocarcinoma of the head of the pancreas: a multicenter, prospective, randomized study. Lymphadenectomy Study Group. Ann Surg. 1998; 228(4):508-17. PMC: 1191525. DOI: 10.1097/00000658-199810000-00007. View

Bramhall S, Allum W, Jones A, Allwood A, Cummins C, Neoptolemos J . Treatment and survival in 13,560 patients with pancreatic cancer, and incidence of the disease, in the West Midlands: an epidemiological study. Br J Surg. 1995; 82(1):111-5. DOI: 10.1002/bjs.1800820137. View

Shoup M, Conlon K, Klimstra D, Brennan M . Is extended resection for adenocarcinoma of the body or tail of the pancreas justified?. J Gastrointest Surg. 2003; 7(8):946-52. DOI: 10.1016/j.gassur.2003.08.004. View

McFaul C, Greenhalf W, Earl J, Howes N, Neoptolemos J, Kress R . Anticipation in familial pancreatic cancer. Gut. 2005; 55(2):252-8. PMC: 1856528. DOI: 10.1136/gut.2005.065045. View

Gouma D, van Geenen R, van Gulik T, de Haan R, de Wit L, Busch O . Rates of complications and death after pancreaticoduodenectomy: risk factors and the impact of hospital volume. Ann Surg. 2000; 232(6):786-95. PMC: 1421271. DOI: 10.1097/00000658-200012000-00007. View

Tamagawa E, Ueda M, Takahashi S, Sugano K, Uematsu S, Mukai M . Pancreatic lymph nodal and plexus micrometastases detected by enriched polymerase chain reaction and nonradioisotopic single-strand conformation polymorphism analysis: a new predictive factor for recurrent pancreatic carcinoma. Clin Cancer Res. 1998; 3(11):2143-9. View

10.

Birkmeyer J, Finlayson S, Tosteson A, Sharp S, Warshaw A, Fisher E . Effect of hospital volume on in-hospital mortality with pancreaticoduodenectomy. Surgery. 1999; 125(3):250-6. View

11.

Hecht S . Cigarette smoking: cancer risks, carcinogens, and mechanisms. Langenbecks Arch Surg. 2006; 391(6):603-13. DOI: 10.1007/s00423-006-0111-z. View

12.

Cameron J, Crist D, Sitzmann J, Hruban R, Boitnott J, Seidler A . Factors influencing survival after pancreaticoduodenectomy for pancreatic cancer. Am J Surg. 1991; 161(1):120-4; discussion 124-5. DOI: 10.1016/0002-9610(91)90371-j. View

13.

Bockman D, Buchler M, Beger H . Interaction of pancreatic ductal carcinoma with nerves leads to nerve damage. Gastroenterology. 1994; 107(1):219-30. DOI: 10.1016/0016-5085(94)90080-9. View

14.

Geer R, Brennan M . Prognostic indicators for survival after resection of pancreatic adenocarcinoma. Am J Surg. 1993; 165(1):68-72; discussion 72-3. DOI: 10.1016/s0002-9610(05)80406-4. View

15.

Beger H, Gansauge F, Siech M, Schwarz M, Poch B . Duodenum-preserving total pancreatic head resection for cystic neoplastic lesions in the head of the pancreas. J Hepatobiliary Pancreat Surg. 2008; 15(2):149-56. DOI: 10.1007/s00534-007-1227-4. View

16.

Okada Y, Eibl G, Duffy J, Reber H, Hines O . Glial cell-derived neurotrophic factor upregulates the expression and activation of matrix metalloproteinase-9 in human pancreatic cancer. Surgery. 2003; 134(2):293-9. DOI: 10.1067/msy.2003.239. View

17.

Neoptolemos J, Stocken D, Dunn J, Almond J, Beger H, Pederzoli P . Influence of resection margins on survival for patients with pancreatic cancer treated by adjuvant chemoradiation and/or chemotherapy in the ESPAC-1 randomized controlled trial. Ann Surg. 2001; 234(6):758-68. PMC: 1422135. DOI: 10.1097/00000658-200112000-00007. View

18.

Nagakawa T, Kayahara M, Ueno K, Ohta T, Konishi I, Ueda N . A clinicopathologic study on neural invasion in cancer of the pancreatic head. Cancer. 1992; 69(4):930-5. DOI: 10.1002/1097-0142(19920215)69:4<930::aid-cncr2820690416>3.0.co;2-r. View

19.

. Further evidence of effective adjuvant combined radiation and chemotherapy following curative resection of pancreatic cancer. Gastrointestinal Tumor Study Group. Cancer. 1987; 59(12):2006-10. DOI: 10.1002/1097-0142(19870615)59:12<2006::aid-cncr2820591206>3.0.co;2-b. View

20.

Yeo C, Cameron J, Lillemoe K, Sitzmann J, Hruban R, Goodman S . Pancreaticoduodenectomy for cancer of the head of the pancreas. 201 patients. Ann Surg. 1995; 221(6):721-31; discussion 731-3. PMC: 1234702. DOI: 10.1097/00000658-199506000-00011. View