Zusammenfassung
Die Diagnose eines Pankreaskarzinoms ist für die Betroffenen aufgrund der ungünstigen Prognose in aller Regel niederschmetternd. Auch wenn eine Heilung nur selten gelingt, konnte die Prognose in jüngster Vergangenheit durch die Entwicklung neuer Substanzen und Therapieregimes substanziell verbessert werden. So wurden etwa neue Operationstechniken entwickelt und adjuvante Therapieoptionen erprobt.
Literatur
Conroy T et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 2011;364(19):1817–25.
Von Hoff DD et al. Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med. 2013;369(18):1691–703.
Jemal A et al. Cancer statistics, 2006. CA Cancer J Clin. 2006;56(2):106–30.
Robert Koch-Institut und die Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V. (2013) Krebs in Deutschland 2009/2010. RKI, Berlin 2013.
Hidalgo M. Pancreatic Cancer. N Engl J Med. 2010;362(17):1605–17.
S3-Leitlinie zum exokrinen Pankreaskarzinom. Version 1.0 — Oktober 2013; AWMF-Registernummer. 032/010OL. Langversion; http://www.awmf.org/uploads/tx_szleitlinien/032-010OLl_S3_Exokrines_Pankreaskarzinom_21112013.pdf; abgerufen am 19.08.2016.
Bansal P et al. Pancreatitis is a risk factor for pancreatic cancer. Gastroenterology. 1995;109(1):247–51.
Ben Q et al. Diabetes mellitus and risk of pancreatic cancer: A meta-analysis of cohort studies. Eur J Cancer. 2011;47(13):1928–37.
Preziosi G et al. Obesity and pancreatic cancer. Surg Oncol. 2014;23(2):61–71.
Schulte A et al. Cigarette smoking and pancreatic cancer risk: more to the story than just pack-years. Eur J Cancer. 2014;50(5):997–1003.
Rhim AD et al. EMT and dissemination precede pancreatic tumor formation. Cell. 2012;148(1-2):349–61.
Michl P et al. Current concepts and novel targets in advanced pancreatic cancer. Gut. 2013;62(2):317–26.
Rau BM et al. R1 resection in pancreatic cancer has significant impact on long-term outcome in standardized pathology modified for routine use. Surgery. 2012;152(3 Suppl 1):S103–11.
Katz MH et al. Borderline resectable pancreatic cancer: need for standardization and methods for optimal clinical trial design. Ann Surg Oncol. 2013;20(8):2787–95.
Oettle H. Progress in the knowledge and treatment of advanced pancreatic cancer: from benchside to bedside. Cancer Treat Rev. 2014;40(9):1039–47.
Takada T et al. Simultaneous hepatic resection with pancreato-duodenectomy for metastatic pancreatic head carcinoma: does it improve survival? Hepatogastroenterology. 1997;44(14):567–73.
Wente MN et al. Pancreaticojejunostomy versus pancreaticogastrostomy: systematic review and meta-analysis. Am J Surg. 2007;193(2):171–83.
Ma S et al. Pancreaticogastrostomy versus pancreaticojejunostomy. J Surg Res. 2014;192(1):68–75.
Shen Y et al. Reconstruction by Pancreaticogastrostomy versus Pancreaticojejunostomy following Pancreaticoduodenectomy: A Meta-Analysis of Randomized Controlled Trials. Gastroenterol Res Pract. 2012;2012:627095.
Morera-Ocon FJ et al. Considerations on pancreatic exocrine function after pancreaticoduodenectomy. World J Gastrointest Oncol. 2014;6(9):325–9.
Yekebas EF et al. En bloc vascular resection for locally advanced pancreatic malignancies infiltrating major blood vessels: perioperative outcome and long-term survival in 136 patients. Ann Surg. 2008;247(2):300–9.
Mollberg N et al. Arterial resection during pancreatectomy for pancreatic cancer: a systematic review and meta-analysis. Ann Surg. 2011;254(6):882–93.
Sasson AR et al. En bloc resection for locally advanced cancer of the pancreas: is it worthwhile? J Gastrointest Surg. 2002;6(2):147–57.
Boggi U et al. Prognostic implications of tumor invasion or adhesion to peripancreatic vessels in resected pancreatic cancer. Surgery. 2009;146(5):869-881.
Callery MP et al. Pretreatment assessment of resectable and borderline resectable pancreatic cancer: expert consensus statement. Ann Surg Oncol. 2009;16(7):1727–33.
Buc E et al. Resection of pancreatic ductal adenocarcinoma with synchronous distant metastasis: is it worthwhile? World J Surg Oncol. 2014;12:347.
Briggs CD et al. Systematic review of minimally invasive pancreatic resection. J Gastrointest Surg. 2009;13(6):1129–37.
Khorana AA et al. Potentially Curable Pancreatic Cancer: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol. 2016;34(21):2541–56.
Oettle H et al. Adjuvant chemotherapy with gemcitabine and longterm outcomes among patients with resected pancreatic cancer: the CONKO-001 randomized trial. JAMA. 2013;310(14):1473–81.
Campbell F et al. Classification of R1 resections for pancreatic cancer: the prognostic relevance of tumour involvement within 1 mm of a resection margin. Histopathology. 2009;55(3):277–83.
Neoptolemos J et al. ESPAC-4: A multicenter, international, open-label randomized controlled phase III trial of adjuvant combination chemotherapy of gemcitabine and capecitabine versus monotherapy gemcitabine in patients with resected pancreatic ductal carcinoma. J Clin Oncol. 2016;34(Suppl):Abstr LBA4006.
Neoptolemos JP et al. Adjuvant chemotherapy with fluorouracil plus folinic acid vs gemcitabine following pancreatic cancer resection: a randomized controlled trial. JAMA. 2010;304(10):1073–81.
Uesaka K et al. Adjuvant chemotherapy of S-1 versus gemcitabine for resected pancreatic cancer: a phase 3, open-label, randomised, noninferiority trial (JASPAC 01). Lancet. 2016;388(10041):248–57.
Liao WC et al. Adjuvant treatments for resected pancreatic adenocarcinoma: a systematic review and network meta-analysis. Lancet Oncol. 2013;14(11):1095–103.
Neoptolemos JP et al. A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer. N Engl J Med. 2004;350(12):1200–10.
Nanda RH et al. Neoadjuvant modified FOLFIRINOX and chemoradiation therapy for locally advanced pancreatic cancer improves resectability. J Surg Oncol. 2015;111(8):1028–34.
Tachezy M et al. Sequential neoadjuvant chemoradiotherapy (CRT) followed by curative surgery vs. primary surgery alone for resectable, non-metastasized pancreatic adenocarcinoma: NEOPA- a randomized multicenter phase III study (NCT01900327, DRKS00003893, ISRCTN82191749). BMC Cancer. 2014;14:411.
Blazer M et al. Neoadjuvant modified (m) FOLFIRINOX for locally advanced unresectable (LAPC) and borderline resectable (BRPC) adenocarcinoma of the pancreas. Ann Surg Oncol. 2015;22(4):1153–9.
Kunzmann V et al. Intensified Neoadjuvant Chemotherapy with Nab- Paclitaxel plus Gemcitabine Followed by FOLFIRINOX in a Patient with Locally Advanced Unresectable Pancreatic Cancer. Case Rep Oncol. 2014;7(3):648–55.
Maraveyas A et al. Gemcitabine versus gemcitabine plus dalteparin thromboprophylaxis in pancreatic cancer. Eur J Cancer. 2012;48(9):1283–92.
Oettle H et al. Second-line oxaliplatin, folinic acid, and fluorouracil versus folinic acid and fluorouracil alone for gemcitabine-refractory pancreatic cancer: outcomes from the CONKO-003 trial. J Clin Oncol. 2014;32(23):2423–9.
Author information
Authors and Affiliations
Corresponding author
Additional information
Interessenkonflikt
Die Autoren erklären, dass sie sich bei der Erstellung des Beitrages von keinen wirtschaftlichen Interessen leiten ließen und dass keine potenziellen Interessenkonflikte vorliegen. Der Verlag erklärt, dass die inhaltliche Qualität des Beitrags von zwei unabhängigen Gutachtern geprüft wurde. Werbung in dieser Zeitschriftenausgabe hat keinen Bezug zur CME-Fortbildung. Der Verlag garantiert, dass die CME-Fortbildung sowie die CME-Fragen frei sind von werblichen Aussagen und keinerlei Produktempfehlungen enthalten. Dies gilt insbesondere für Präparate, die zur Therapie des dargestellten Krankheitsbildes geeignet sind.
Rights and permissions
About this article
Cite this article
Oettle, H., Lehmann, T.G. Therapiestrategien für Patienten mit Pankreaskarzinom. Im Focus Onkologie 19, 58–66 (2016). https://doi.org/10.1007/s15015-016-2284-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s15015-016-2284-9