Skip to main content

Pancreatic Cancer

  • Chapter
  • First Online:
Image-Guided Interventions in Oncology
  • 385 Accesses

Abstract

Pancreatic cancer is the third leading cause of cancer death in the United States, and estimates suggest it will become the second leading cause of cancer death by 2030. Pancreatic cancer is a particularly aggressive and lethal malignancy, with approximately 93% of pancreatic cancer patients dying within 5 years of diagnosis. Patients with metastatic pancreatic cancer have a worse prognosis, with an approximately 3–6-month life expectancy. For the subgroup of patients with disease localized to the pancreas, surgery is the only curative option. Unfortunately, the initial presentation for many patients is with unresectable disease; thus, oncologists frequently employ preoperative treatment to try to shrink the tumor and improve surgical outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Rahib L, Smith BD, Aizenberg R, Rosenzweig AB, Fleshman JM, Matrisian LM. Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Cancer Res. 2014;74:2913–21.

    Article  CAS  PubMed  Google Scholar 

  2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin. 2017;67:7–30.

    Article  PubMed  Google Scholar 

  3. American Cancer Society. Cancer facts & figures 2016. Atlanta: American Cancer Society; 2016.

    Google Scholar 

  4. Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin. 2010;60:277–300.

    Article  PubMed  Google Scholar 

  5. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2006. CA Cancer J Clin. 2006;56:106–30.

    Article  PubMed  Google Scholar 

  6. Hawes RH, Xiong Q, Waxman I, Chang KJ, Evans DB, Abbruzzese JL. A multispecialty approach to the diagnosis and management of pancreatic cancer. Am J Gastroenterol. 2000;95:17–31.

    Article  CAS  PubMed  Google Scholar 

  7. Sultana A, Smith CT, Cunningham D, Starling N, Neoptolemos JP, Ghaneh P. Meta-analyses of chemotherapy for locally advanced and metastatic pancreatic cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2007;25:2607–15.

    Article  Google Scholar 

  8. Faris JE, Blaszkowsky LS, McDermott S, et al. FOLFIRINOX in locally advanced pancreatic cancer: the Massachusetts General Hospital Cancer Center experience. Oncologist. 2013;18:543–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Ferrone CR, Marchegiani G, Hong TS, et al. Radiological and surgical implications of neoadjuvant treatment with FOLFIRINOX for locally advanced and borderline resectable pancreatic cancer. Ann Surg. 2015;261:12–7.

    Article  PubMed  Google Scholar 

  10. Conroy T, Desseigne F, Ychou M, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 2011;364:1817–25.

    Article  CAS  PubMed  Google Scholar 

  11. Von Hoff DD, Ervin T, Arena FP, et al. Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med. 2013;369:1691–703.

    Article  CAS  Google Scholar 

  12. Murphy JE, Wo JY, Ryan DP, et al. Total neoadjuvant therapy with FOLFIRINOX in combination with losartan followed by chemoradiotherapy for locally advanced pancreatic cancer: a phase 2 clinical trial. JAMA Oncol. 2019;5:1020–7.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Ryan DP, Hong TS, Bardeesy N. Pancreatic adenocarcinoma. N Engl J Med. 2014;371:2140–1.

    Article  PubMed  CAS  Google Scholar 

  14. Boone BA, Steve J, Krasinskas AM, et al. Outcomes with FOLFIRINOX for borderline resectable and locally unresectable pancreatic cancer. J Surg Oncol. 2013;108:236–41.

    Article  CAS  PubMed  Google Scholar 

  15. Hosein PJ, Macintyre J, Kawamura C, et al. A retrospective study of neoadjuvant FOLFIRINOX in unresectable or borderline-resectable locally advanced pancreatic adenocarcinoma. BMC Cancer. 2012;12:199.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Geer RJ, Brennan MF. Prognostic indicators for survival after resection of pancreatic adenocarcinoma. Am J Surg. 1993;165:68–72; discussion −3.

    Article  CAS  PubMed  Google Scholar 

  17. Trede M, Schwall G, Saeger HD. Survival after pancreatoduodenectomy. 118 consecutive resections without an operative mortality. Ann Surg. 1990;211:447–58.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Yeo CJ, Cameron JL, Sohn TA, et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. Ann Surg. 1997;226:248–57; discussion 57–60.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Perysinakis I, Avlonitis S, Georgiadou D, Tsipras H, Margaris I. Five-year actual survival after pancreatoduodenectomy for pancreatic head cancer. ANZ J Surg. 2015;85:183–6.

    Article  PubMed  Google Scholar 

  20. Cortez-Retamozo V, Engblom C, Pittet MJ. Remote control of macrophage production by cancer. Onco Targets Ther. 2013;2:e24183.

    Google Scholar 

  21. Cortez-Retamozo V, Etzrodt M, Newton A, et al. Angiotensin II drives the production of tumor-promoting macrophages. Immunity. 2013;38:296–308.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Temel JS, Greer JA, El-Jawahri A, et al. Effects of early integrated palliative care in patients with lung and GI cancer: a randomized clinical trial. J Clin Oncol Off J Am Soc Clin Oncol. 2017;35:834–41.

    Article  Google Scholar 

  23. Smyth EN, Bapat B, Ball DE, Andre T, Kaye JA. Metastatic pancreatic adenocarcinoma treatment patterns, health care resource use, and outcomes in France and the United Kingdom between 2009 and 2012: a retrospective study. Clin Ther. 2015;37:1301–16.

    Article  PubMed  Google Scholar 

  24. Dias-Santos D, Ferrone CR, Zheng H, Lillemoe KD, Fernandez-Del CC. The Charlson age comorbidity index predicts early mortality after surgery for pancreatic cancer. Surgery. 2015;157:881–7.

    Article  PubMed  Google Scholar 

  25. Barugola G, Falconi M, Bettini R, et al. The determinant factors of recurrence following resection for ductal pancreatic cancer. JOP. 2007;8:132–40.

    PubMed  Google Scholar 

  26. Greer JA, Pirl WF, Jackson VA, et al. Perceptions of health status and survival in patients with metastatic lung cancer. J Pain Symptom Manag. 2014;48:548–57.

    Article  Google Scholar 

  27. Weeks JC, Catalano PJ, Cronin A, et al. Patients’ expectations about effects of chemotherapy for advanced cancer. N Engl J Med. 2012;367:1616–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Epstein AS, Prigerson HG, O’Reilly EM, Maciejewski PK. Discussions of life expectancy and changes in illness understanding in patients with advanced cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2016;34:2398–403.

    Article  Google Scholar 

  29. Gramling R, Fiscella K, Xing G, et al. Determinants of patient-oncologist prognostic discordance in advanced cancer. JAMA Oncol. 2016;2(11):1421–6.

    PubMed  PubMed Central  Google Scholar 

  30. Steinhauser KE, Christakis NA, Clipp EC, et al. Preparing for the end of life: preferences of patients, families, physicians, and other care providers. J Pain Symptom Manag. 2001;22:727–37.

    Article  CAS  Google Scholar 

  31. Steinhauser KE, Christakis NA, Clipp EC, McNeilly M, McIntyre L, Tulsky JA. Factors considered important at the end of life by patients, family, physicians, and other care providers. JAMA. 2000;284:2476–82.

    Article  CAS  PubMed  Google Scholar 

  32. Steinhauser KE, Clipp EC, McNeilly M, Christakis NA, McIntyre LM, Tulsky JA. In search of a good death: observations of patients, families, and providers. Ann Intern Med. 2000;132:825–32.

    Article  CAS  PubMed  Google Scholar 

  33. Lundquist G, Rasmussen BH, Axelsson B. Information of imminent death or not: does it make a difference? J Clin Oncol Off J Am Soc Clin Oncol. 2011;29:3927–31.

    Article  Google Scholar 

  34. Smith TJ, Dow LA, Virago E, Khatcheressian J, Lyckholm LJ, Matsuyama R. Giving honest information to patients with advanced cancer maintains hope. Oncology. 2010;24:521–5.

    PubMed  Google Scholar 

  35. Zhang B, Wright AA, Huskamp HA, et al. Health care costs in the last week of life: associations with end-of-life conversations. Arch Intern Med. 2009;169:480–8.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Eisenberg E, Carr DB, Chalmer TC. Neurolytic celiac plexus block for treatment of cancer pain: a meta-analysis. Anesth Analg. 1995;80:290–5.

    CAS  PubMed  Google Scholar 

  37. Kaugman M, Singh G, Das S, Concha-Parra R, et al. Efficacy of endoscopic ultrasound guided celiac plexus block and celiac plexus neurolysis for managing abdominal pain associated with chronic pancreatitis and pancreatic cancer. J Clin Gastroenterol. 2010;44:127–34.

    Article  Google Scholar 

  38. Loukas M, Klaasen A, Merbs W, Tubbs RS, Gielecki J, Zurada A. A review of the thoracic splanchnic nerves and celiac ganglia. Clin Anat. 2010;23(5):512–22.

    Article  PubMed  Google Scholar 

  39. Fujita Y, Sari A. Max Kappis and the celiac plexus block. Anesthesiology. 1997;86:508.

    Article  CAS  PubMed  Google Scholar 

  40. Wang PJ, Shang MY, Qian Z, Shao CW, Wang JH, Zhao XH. CT-guided percutaneous neurolytic celiac plexus block technique. Abdom Imaging. 2006;31(6):710–8.

    Article  CAS  PubMed  Google Scholar 

  41. Sachev AH, Gress FG. Celiac plexus block and neurolysis: a review. Gastrointest Endosc Clin N Am. 2018;28(4):579–86.

    Article  Google Scholar 

  42. Silk M, Tahour D, Srimathveeravalli G, Solomon SB, Thornton RH. The state of irreversible electroporation in interventional oncology. Semin Intervent Radiol. 2004;31:111–7.

    Article  Google Scholar 

  43. Scheffer HJ, Nielsen K, de Jong MC, et al. Irreversible electroporation for nonthermal tumor ablation in the clinical setting: a systematic review of safety and efficacy. J Vasc Interv Radiol. 2014;25:997–1011.

    Article  PubMed  Google Scholar 

  44. Charpentier KP, Wolf F, Noble L, Winn B, Resnick M, Dupuy DE. Irreversible electroporation of the pancreas in swine: a pilot study. HPB (Oxford). 2010;12:348–51.

    Article  Google Scholar 

  45. Bower M, Sherwood L, Li Y, Martin R. Irreversible electroporation of the pancreas: definitive local therapy without systemic effects. J Surg Oncol. 2011;104:22–8.

    Article  PubMed  Google Scholar 

  46. Narayanan G, Bhatia S, Echenique A, Suthar R, Barbery K, Yrizarry J. Vessel patency post irreversible electroporation. Cardiovasc Intervent Radiol. 2014;37:1523–9.

    Article  PubMed  Google Scholar 

  47. Flak RV, Stender MT, Jensen TM, Andersen KL, et al. Treatment of locally advanced pancreatic cancer with irreversible electroporation; A Danish single center study of safety and feasibility. Scand J Gastroenterol. 2019;54(2):252–8.

    Article  PubMed  Google Scholar 

  48. Meyer F, Grote R, Lippert H, Ridwelski K. Marginal effects of regional intra-arterial chemotherapy as an alternative treatment option in advanced pancreatic carcinoma. Langenbeck’s Arch Surg. 2004 Feb.;389:32–9.

    Article  Google Scholar 

  49. Bailey RE, Srapanemi PK, Core J, Vidal LLC, LeGout J, et al. Safety and efficacy of locoregional therapy for metastatic pancreatic ductal adenocarcinoma to the liver: a single-center experience. J Gastrointest Oncol. 2019;10:688–94.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Sun JH, Zhou TY, Zhang YL, Zhou GH, et al. Efficacy of transcatheter arterial chemoembolization for liver metastases arising from pancreatic cancer. Oncotarget. 2017;8:39746–55.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Kim AY, Frantz S, Bower J, Akhter N. Radioembolization with Yttrium-90 microspheres for the treatment of LIver metastases of pancreatic adenocarcinoma: a multicenter analysis. J Vasc Interv Radiol. 2019;30:298–304.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ronald S. Arellano .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Arellano, R.S., Nipp, R. (2020). Pancreatic Cancer. In: Georgiades, C., Kim, H. (eds) Image-Guided Interventions in Oncology. Springer, Cham. https://doi.org/10.1007/978-3-030-48767-6_17

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-48767-6_17

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-48766-9

  • Online ISBN: 978-3-030-48767-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics