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. 2008 Apr;105(14):255-62.
doi: 10.3238/arztebl.2008.0255. Epub 2008 Apr 4.

Pancreatic cancer--low survival rates

Hans G Beger  1 , Bettina Rau, Frank Gansauge, Gerd Leder, Michael Schwarz, Bertram Poch
Affiliations

Pancreatic cancer--low survival rates

Hans G Beger et al. Dtsch Arztebl Int. 2008 Apr.

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.

Keywords: R0-resection; adjuvant chemotherapy; early cancer dissemination into nerves; lymph tissue and blood circulation; pancreatic cancer; systemic disease.

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Figures

Figure 1
Figure 1
Pancreatic cancer, diagnostic algorithm (Surgical Clinic I, Ulm University Hospital)
Figure 2
Figure 2
Operative site after standardized resection of a pancreas head cancer. Portal vein and superior mesenteric vein (blue strip) dissected free from tissue; dorsal: intrahepatic vena cava and aorta. Aortocaval space dissected free from lymph nodes (Ulm University Surgical Clinic, Department of General and Visceral Surgery).
Figure 3
Figure 3
Survival times of 172 patients post resection of a ductal pancreatic cancer in UICC stage III (Ulm University Surgical Clinic [1982-1997])
See this image and copyright information in PMC

Comment in

  • Gemcitabine more useful.
    Geibler M. Geibler M. Dtsch Arztebl Int. 2008 Sep;105(38):655; author reply 655-6. doi: 10.3238/arztebl.2008.0655. Epub 2008 Sep 19. Dtsch Arztebl Int. 2008. PMID: 19471637 Free PMC article. No abstract available.

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