#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

New Options for Pancreatic Cancer Diagnostics


Authors: J. Kaťuchová;  J. Bober;  P. Harbuľák;  J. Radoňak
Authors‘ workplace: I. chirurgická klinika LF UPJŠ a UNLP Košice, Slovenská republika, prednosta: prof. MUDr. J. Radoňak, CSc.
Published in: Rozhl. Chir., 2011, roč. 90, č. 3, s. 184-189.
Category: Monothematic special - Original

Overview

Introduction:
The overall 5-year survival rate for patients with pancreatic cancer remains poor, ranging between 5% and 15%, with a median survival of 13 to 17 months. Looking for the new possibilities can identify early-stage pancreatic cancer patients.

Material and Methods:
The comparative study was performed at the I. Department of Surgery University Hospital in Košice, between group of pancreatic cancer patients, whose were operated during 1. 1. 1996–31. 12. 2000 group A and during 1. 1. 2005–31. 12. 2009 group B. The survival rate was compared in all groups of patients and in group of patients in stages of pancreatic cancer.

From 2007, there were started a trial, in which lymph nodes were observed using histopathological and immunohistochemical examination.

Results:
In group A (1. 1. 1996–31. 12. 2000) were presented 29 patients, 5 years survival was investigated in two patients (6.8%), median survival rate was 14 months. In group B (1. 1. 2005–31. 12. 2009) were presented 51 patients, no patient survival 5 years, median survival rate was 14 months.

Between January 2007 and December 2009 one hundred and eight pancreatic cancer patients were treated at the I. Department of Surgery University Hospital in Košice. The radical pancreatic resection and standard lymphadenectomy were performed in 36 patients. During standard lymphadenectomy there were found 19 patients with 119 negative lymph nodes by histopathological examination. These lymph nodes were examined by immunohistological examination, and there were found 37 lymph nodes as positive, in 6 patients.

Conclusion:
Patients in earlier stage of pancreatic cancer had better survival rates than in later stage of disease. Immunohistochemical examination of histopathologically negative lymph nodes can detect positive lymph nodes and early-stage pancreatic cancer patients can be identified.

Key words:
pancreatic cancer – pancreatic resection – survival rate – lymph nodes – histopathological examination – immunohistochemical examination


Sources

1. Alexalis, N., Halloran, C., Raraty, M., et al. Current standards of surgery for pancreatic cancer. Br. J. Surg., 2004; 91: 410–427.

2. Beger, H. G., Matsuno, S., Cameron, J. L. Diseases of the pancreas. 1st ed. Berlin Heidelberg New York, Springer-Verlag, 2008.

3. Bober, J., Blažej, I., Sabo-Nácko, J., et al. Karcinóm pankreasu-diagnostika, chirurgická liečba, výsledky. Folia Medica Cassoviensia Universitas Šafarikiana, 1996; 53: 84–89.

4. Kothaj, P. Chirurgická liečba rakoviny pankreasu. 1. vyd. Banská Bystrica, Spektrum 1997.

5. Brennan, M. F., Kattan, M. W., Klimstra, D., et al. Prognostic nomogram for patients undergoing resection for adenocarcinoma of the pancreas. Ann. Surg., 2004; 240: 293–298.

6. Ryder, N. M., Reber, H. A. Pancreatic surgery. Curr. Opin. Gastroenterol., 2000; 16: 426–430.

7. Doi, R., Kami, K., Ito, D., et al. Prognostic implication of para-aortic lymph node metastasis in resectable pancreatic cancer. World J. Surg., 2007; 31: 147–154.

8. Neoptolemos, J. P., Stocken, D. D., Dunn, J. A., et al. 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: 758–768.

9. Zervos, E. E., Rosemurgy, A. S., Al-Saif, O., et al. Surgical management of early-stage pancreatic cancer. Cancer control, 2004; 11: 23–31.

10. Krechler, T., Novotný, J., Zeman, M., et al. Karcinom pankreatu a diabetes mellitus. Čas. Lék. Čes., 2004; 143: 97–100.

11. Schmidt, C. M., Powel, W. S., Yiannoutsos, C. T., et al. Pancreaticoduodenectomy. A 20-years experience in 516 patients. Arch. Surg., 2004; 139: 718–727.

12. Yeo, C. J.,Cameron, J. L., Lillemoe, K. D., et al. Pancreaticoduodenectomy with or without distal gastrectomy and extended retroperitoneal lymphadenectomy for periampullary adenocarcinoma, part 2. Randomized control trial evaluating survival, mortality and morbidity. Ann. Surg., 2002; 236: 355–368.

13. Nakao, A. Debate: extended resection for pancreatic cancer; the affirmative case. J. Hepatobiliary Pancreat. Surg., 2003; 10: 57–60.

14. Pawlik, T. M., Abdalla, E. K., Barnett, C. C., et al. Feasibility of a randomized trial of extended lymphadenectomy for pancreatic cancer. Arch. Surg., 2005; 140: 584–591.

15. Siriwardana, H. P., Siriwardena, A. K. Systematic review of outcome of synchronous portal-superior mesenteric vein resection during pancreatectomy for cancer. Br. J. Surg., 2006; 93: 662–673.

16. Pedrazzoli, S., Beger, H. G., Obertop, H., et al. A surgical and pathological based classification of resective treatment of pancrea­tic cancer. Dig. Surg., 1999; 16: 337–345.

17. Wagner, M., Redaeelli, C., Lietz, M., et al. Curative resection is the single most important factor determining outcome in patients with pancreatic adenocarcinoma. Br. J. Surg., 2004; 91: 586–594.

18. Bogoevski, D., Yekebas, E. F., Schurr, P., et al. Mode of spread in the early phase of lymphatic metastasis in pancreatic ductal adenocarcinoma: Prognostic significance of nodal microinvolvement. Ann. Surg., 2004; 240: 993–1001.

19. Zavoral, M., et al. Karcinom pankreatu. 1. vyd. Praha, Galén, 2005.

20. Scheunemann, P., Stoecklein, N., Bidde, M., et al. Occult tumor cells in lymph nodes as a predictor for tumor relapse in pancreatic adenocarcinoma. Langenbecks Arch. Surg., 2008; 393: 359–365.

21. Niedrgethmann, M., Rexin, M., Hildebrand, R., et al. Prognostic implications of routine immunohistochemical, and molecular staging in resectable pancreatic adenocarcinoma. Am. J. Surg. Pathol., 2002; 26: 1578–1587.

22. Gockel, I., Domeyer, M., Wolloscheck, T., et al. Resection of the mesopancreas (RMP): a new surgical classification of a known anatomical space. World Journal of Surgical Oncology, 2007; 5: 44–51.

23. Mizano, T., Ishizaki, Y., Ogura, K., et al. Clinical significance of immunohistochemically detectable lymph node metastasis in adenocarcinoma of the ampula of Vater. Br. J. Surg., 2006; 93: 221–225.

Labels
Surgery Orthopaedics Trauma surgery
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#