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Kurativ-operative Therapie des Pankreaskarzinoms

Curative surgical treatment of pancreatic cancer

  • Leitthema
  • Published:
Der Onkologe Aims and scope

Zusammenfassung

In den westlichen Industrienationen sterben jährlich ca.150.000 Patienten an einem Pankreaskarzinom, davon allein ca. 40.000 in Europa. Damit ist das Pankreaskarzinom die viert- bis fünfthäufigste Todesursache bei Krebserkrankungen in der westlichen Welt. Mit einer insgesamt beschriebenen Fünfjahresüberlebensrate von weniger als 1% stellt das Pankreaskarzinom somit eine der aggressivsten Tumorerkrankungen überhaupt dar. Die Tumorresektion ist nach wie vor die einzige Möglichkeit, das Pankreaskarzinom zu heilen. Trotz großer klinischer Anstrengungen hat sich die Langzeitprognose von Pankreaskarzinompatienten nur unwesentlich verändert. Die Chirurgie des Pankreaskarzinoms hat in den vergangenen 10 Jahren allerdings wesentliche Fortschritte gemacht, und heute können mehr Patienten reseziert und die Operation sicher und mit geringer Morbidität und Mortalität ausgeführt werden. Ein großes Problem stellt die frühzeitige Diagnose dar. Nur 10–15% aller Patienten mit der Diagnose eines Pankreaskarzinoms werden in einem resektablen Stadium diagnostiziert. Die dabei erzielten Fünfjahresüberlebensraten konnten in der Vergangenheit auf ungefähr 25% gesteigert werden, sind aber weiterhin nicht befriedigend. Auf der anderen Seite tragen die niedrige Ansprechrate auf Chemotherapeutika, Radiotherapie, Immuntherapie und antihormonale Therapien zur schlechten Prognose von diesen Patienten bei.

Abstract

Pancreatic cancer is still a devastating disease, which is presently the fourth or fifth leading cause of cancer-related death in Western countries with a poor prognosis even after tumor resection. Approximately 150,000 people worldwide and 40,000 people in Europe die each year of pancreatic cancer, making it one of the most aggressive human tumors. An overall 5-year survival of less than 1% is frequently reported and little has changed in recent decades. Complete resection of the entire tumor is still the only possibility to cure pancreatic carcinoma. Despite many clinical improvements, only little has changed in the long-term survival of patients with pancreatic cancer. Due to essential improvements in the field of surgery in the last decade, it is nowadays possible to resect more patients and the operative procedures have become safer in terms of morbidity and mortality. It is still a challenging task to diagnose pancreatic cancer in early tumor stages, because the disease usually becomes symptomatic at an advanced stage. Therefore, the overall resectability rate of pancreatic cancer is only 10–15%. On the other hand, low responsiveness to chemotherapy, radiotherapy, immunotherapy, and antihormonal treatment contributes to the poor prognosis. These facts together result in low resectability rates after diagnosis, early tumor recurrence after resection, and poor overall survival rates.

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Authors and Affiliations

  1. Abt. für Allgemein-, Viszeral- und Unfallchirurgie, Universität Heidelberg

    B. M. Künzli, H. Friess, J. Kleeff &  M. W. Büchler

  2. Klinik und Poliklinik für Allgemein-, Viszeral- und Thoraxchirurgie, Universität Hamburg

    E. Yekebas, O. Mann & J. R. Izbicki

  3. Abt. für Allgemein-, Viszeral- und Unfallchirurgie, Universität Heidelberg, Im Neuenheimer Feld 110, 69120 , Heidelberg

    M. W. Büchler

Authors
  1. B. M. Künzli
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  2. H. Friess
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  3. J. Kleeff
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  4. E. Yekebas
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  5. O. Mann
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  6. J. R. Izbicki
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  7. M. W. Büchler
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Correspondence to M. W. Büchler.

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Künzli, B.M., Friess, H., Kleeff, J. et al. Kurativ-operative Therapie des Pankreaskarzinoms. Onkologe 10, 1285–1300 (2004). https://doi.org/10.1007/s00761-004-0796-y

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  • DOI: https://doi.org/10.1007/s00761-004-0796-y

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