Pancreatic cancer: a generalized disease—prognostic impact of cancer cell dissemination
- D. BogoevskiAffiliated withDepartment of General, Visceral- and Thoracic-Surgery, University Medical Centre of Hamburg-Eppendorf Email author
- , T. StrateAffiliated withDepartment of General, Visceral- and Thoracic-Surgery, University Medical Centre of Hamburg-Eppendorf
- , E. F. YekebasAffiliated withDepartment of General, Visceral- and Thoracic-Surgery, University Medical Centre of Hamburg-Eppendorf
- , J. R. IzbickiAffiliated withDepartment of General, Visceral- and Thoracic-Surgery, University Medical Centre of Hamburg-Eppendorf
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Pancreatic ductal adenocarcinoma is the fifth leading cause of death among all malignancies, leading to approximately 40,000 deaths each year in Europe. The annual incidence rate for all types of pancreatic cancer is approximately nine new cases per 100,000 people, ranking it as the 11th among all cancers. Stage, grade and resection margin status are currently accepted as the most accurate pathologic variables predicting survival. All classification systems fail prognostically to distinguish between different stages. Even in patients with seemingly early tumours (T1, N0), the likelihood of relapse is high. This reflects the shortcomings of the pathologic staging to sufficiently discriminate patients with a high risk to develop tumour recurrence from those that carry a lower risk.
On the other hand, none of the currently used systems includes or takes into consideration the role of disseminated tumour cells neither in the lymph nodes nor in the bone marrow. Occult residual tumour disease is suggested when either bone marrow or lymph nodes, from which tumour relapse may originate, are affected by micrometastatic lesions undetectable by conventional histopathology. For detection, antibodies against tumour-associated targets can be used to detect individual epithelial tumour cells both in lymph nodes and in bone marrow. The clinical significance of these immunohistochemical analyses is still controversial. Various monoclonal antibodies are still in use for micrometastatic detection, thus contributing to the incongruity of data and validity of results. These assays have been rarely used in patients with pancreatic carcinoma.
The presence or absence of lymph-node metastases can predict the likelihood of survival for most, if not all, patients with pancreatic ductal adenocancer and the likelihood that metastases will develop at distant sites.
KeywordsPancreatic adenocarcinoma Micrometastases Immunohistochemistry
- Pancreatic cancer: a generalized disease—prognostic impact of cancer cell dissemination
Langenbeck's Archives of Surgery
Volume 393, Issue 6 , pp 911-917
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Pancreatic adenocarcinoma
- Industry Sectors