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Advances in the diagnosis and treatment of adenocarcinoma of the pancreas

  • Chapter
Surgical Oncology

Part of the book series: Cancer Treatment and Research ((CTAR,volume 90))

Abstract

Pancreatic cancer is the fifth leading cause of adult cancer mortality. The etiology of cancer of the pancreas remains a mystery despite the implication of various agents, such as coffee, alcohol, and cigarettes. The current management of patients with pancreatic cancer at our institution involves: (1) a selective approach to the use of laparotomy based on accurate radiographic imaging techniques, and the availability of reliable minimally invasive techniques for biliary decompression; (2) the use of multimodality therapy in all patients with localized, potentially resectable disease; and (3) a standardized approach to surgery and perioperative patient management. The goals of this approach are to maximize the length and quality of patient survival while minimizing treatment-related toxicity and limiting the social and economic impact of complicated, multimodality therapy. However, less than 5% of patients with adenocarcinoma of the pancreas will be alive 5 years after diagnosis. Therefore, clinical and basic science research is proceeding in parallel: while attempting to optimize the length and quality of life of patients with localized pancreatic tumors, research is also focusing on developing improved strategies for early diagnosis and effective systemic therapy.

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References

  1. Staley CA, Lee JE, Cleary KA, et al. Preoperative chemoradiation, pancreatico-duodenectomy, and intraoperative radiation therapy for adenocarcinoma of the pancreatic head. Am J Surg, 171: 118–125, 1996.

    Article  PubMed  CAS  Google Scholar 

  2. Geer RJ, Brennan MF. Prognostic indicators for survival after resection of pancreatic adenocarcinoma. Am J Surg 165: 68–73, 1993.

    Article  PubMed  CAS  Google Scholar 

  3. Gastrointestinal Tumor Study Group. A multi-institutional comparative trial of radiation therapy alone and in combination with 5-fluorouracil for locally unresectable pancreatic carcinoma. Ann Surg 189: 205–208, 1979.

    Google Scholar 

  4. Whittington R, Neuberg D, Tester WJ, et al. Protracted intravenous fluorouracil infusion with radiation therapy in the management of localized pancreaticobiliary carcinoma: A phase I Eastern Cooperative Oncolongy Group trial. J Clin Oncol 13: 227–232, 1995.

    PubMed  CAS  Google Scholar 

  5. Nitecki SS, Sarr MG, Colby TV, vanHeerden JA. Long-term survival after resection for ductal adenocarcinoma of the pancreas. Is it really improving? Ann Surg 221: 59–66, 1995.

    CAS  Google Scholar 

  6. Trede M, Chir B, Schwall G, Saeger H. Survival after pancreaticoduodenectomy: 118 consecutive resections without an operative mortality. Ann Surg 211: 447–458, 1990.

    Article  PubMed  CAS  Google Scholar 

  7. Whittington R, Bryer MP, Haller DG, Solin LJ, Rosato EF. Adjuvant therapy of resected adenocarcinoma of the pancreas. Int J Radiat Oncol Biol Phys 21: 1137–1143, 1991.

    Article  PubMed  CAS  Google Scholar 

  8. Willet CG, Lewandrowski K, Warshaw AL, et al. Resection margins in carcinoma of the head of the pancreas: Implications for radiation therapy. Ann Surg 217: 144–148, 1993.

    Article  Google Scholar 

  9. Yeo CJ, Cameron JL, Lillemore KD, et al. Pancreaticoduodenectomy for cancer of the head of the pancreas: 201 patients. Ann Surg 221: 721–733, 1995.

    Article  PubMed  CAS  Google Scholar 

  10. Tepper J, Nardi G, Suit H. Carcinoma of the pancreas: Review of MGH experience from 1963-1973. Cancer 37: 1519–1524, 1976.

    Article  PubMed  CAS  Google Scholar 

  11. Fuhrman GM, Charnsangavej C, Abbruzzese JL. Thin-section contrast enhanced computed tomography accurately predicts resectability of malignant pancreatic neoplasms. Am J Surg 167: 104–113, 1994.

    Article  PubMed  CAS  Google Scholar 

  12. de Rooij PD, Rogatko A, Brennan MF. Evaluation of palliative surgical procedures in unresectable pancreatic cancer. Br J Surg 78: 1053–1058, 1991.

    Article  PubMed  Google Scholar 

  13. Lillemoe KD, Sauter PK, Pitt HA, et al. Current status of surgical palliation of periampullary carcinoma. Surg Gynecol Obstet 176: 1–10, 1993.

    PubMed  CAS  Google Scholar 

  14. Alvarez C, Livingston EH, Ashley SW, et al. Cost-benefit analysis of work-up for pancreatic cancer. Am J Surg 165: 53–60, 1993.

    Article  PubMed  CAS  Google Scholar 

  15. Evans DB, Lee JE, Leach SD, et al. Vascular resection and intraoperative radiation therapy during pancreaticoduodenectomy: Rationale and technique. Adv Surg 29: 235–262, 1995.

    Google Scholar 

  16. Evans DB, Lee JE, Pisters PWT. Pancreaticoduodenectomy (Whipple operation) and total pancreatectomy for cancer. In Nyhus LM, Baker RJ, Fishcer JF (eds). Mastery of Surgery, 3rd ed. Boston: Little, Brown 1997, pp 1233–1249.

    Google Scholar 

  17. Tyler DS, Evans DB. Reoperative pancreaticoduodenectomy. Ann Surg 2: 211–221, 1994.

    Article  Google Scholar 

  18. Moertel CG, Childs DS, Reitemeier RJ, et al. Combined 5-fluorouracil and supervoltage radiation therapy of locally unresectable gastrointestinal cancer. Lancet 2: 865–867, 1969.

    Article  PubMed  CAS  Google Scholar 

  19. Moertel CG, Frystak S, Hahn RG, et al. Therapy of locally unresectable pancreatic carcinoma: A randomized comparison of high dose (6000 rads) radiation alone, moderate dose radiation and 5-fluorouracil. Cancer 48: 1705–1710, 1981.

    Article  PubMed  CAS  Google Scholar 

  20. Gastrointestinal Tumor Study Group. Furgher evidence of effective adjuvant combined radiation and chemotherapy following curative resection of pancreatic cancer. Cancer 59: 2006–2010, 1987.

    Article  Google Scholar 

  21. Kaiser MH, Ellenberg SS. Pancreatic cancer: Adjuvant combined radiation and chemotherapy following curative resection. Arch Surg 120: 899–903, 1985.

    Article  Google Scholar 

  22. Bakkevold KE, Arnesjo B, Dahl O, Kambestad B. Adjuvant combination chemotherapy (AMF) following radical resection of carcinoma of the pancreas and papilla of vater — results of a controlled, prospective, randomized multicentre study. Eur J Cancer 29A: 698, 1995.

    Google Scholar 

  23. Neoptolemos JP, Kerr DJ. Adjuvant therapy for pancreatic cancer. Br J Surg 82: 1012–1014, 1995.

    Article  PubMed  CAS  Google Scholar 

  24. Ishikawa O, Ohhigashi H, Teshima T, et al. Clinical and histopathological appraisal of preoperative irradiation for adenocarcinoma of the pancreaticoduodenal region. J Surg Oncol 40: 143–151, 1989.

    Article  PubMed  CAS  Google Scholar 

  25. Pilepich MV, Miller HH. Preoperative irradiation in carcinoma of the pancreas. Cancer 46: 1945–1949, 1980.

    Article  PubMed  CAS  Google Scholar 

  26. Kopelson G. Curative surgery for adenocarcinoma of the pancreas/ampulla of Vater: The role of adjuvant pre-or postoperative radiation therapy. Int J Radiat Oncol Biol Phys 9: 911–915, 1983.

    Article  PubMed  CAS  Google Scholar 

  27. Evans DB, Rich TA, Byrd DR, et al. Preoperative chemoradiation and pan-creaticoduodenectomy for adenocarcinoma of the pancreas. Arch Surg 127: 1335–1339, 1992.

    Article  PubMed  CAS  Google Scholar 

  28. Hoffman JP, Weese JL, Solin LJ, et al. A single institutional experience with preoperative chemoradiation for stage I—III pancreatic adenocarcinoma. Am Surg 59: 772–781, 1993.

    PubMed  CAS  Google Scholar 

  29. Jessup JM, Steele G, Mayer RJ, et al. Neoadjuvant therapy for unresectable pancreatic adenocarcinoma. Arch Surg 128: 559–564, 1993.

    Article  PubMed  CAS  Google Scholar 

  30. Wanebo HJ, Posher M, Glicksman M, et al. Integrated modality protocol for carcinoma of the pancreas: Pilot program (abstr). Proc Am Soc Clin Oncol 10: 158, 1991.

    Google Scholar 

  31. Spitz FR, Abbruzzese JL, Lee JE, et al. Preoperative and Postoperative Chemoradiation Strategies in Patients Treated with Pancreaticoduodenectomy for Adenocarcinoma of the Pancreas. J Clin Oncol. 15: 928–937, 1997.

    PubMed  CAS  Google Scholar 

  32. Evans DB, Abbruzzese J, Lee J, et al. Preoperative chemoradiation and pancreaticoduodenectomy for adenocarcinoma of the pancreas (abstr). Proc Am Soc Clin Oncol 13: 226, 1994.

    Google Scholar 

  33. Hoffman JP, Weese JL, Solin LJ, et al. Preoperative chemoradiation for patients with resectable pancreatic adenocarcinoma: An Eastern Cooperative Oncology Group (ECOG) phase II study (abstr). Proc Am Soc Clin Oncol 14: 201, 1995.

    Google Scholar 

  34. Whittington R, Bryer MP, Haller DG, Solin LJ, Rosato EF. Adjuvant therapy of resected adenocarcinoma of the pancreas. Int J Radiat Oncol Biol Phys 21: 1137–1143, 1991.

    Article  PubMed  CAS  Google Scholar 

  35. Evans DB, Abbruzzese JL, Rich TA. Cancer of the pancreas. In DeVita VT Jr, Hellmans, Rosenberg SA (eds). Cancer: Principles and Practice of Oncology (eds). Philadelphia, PA, Lippin cott, 1997, pp 1054–1087.

    Google Scholar 

  36. Moore GE, Sako Y, Thomas LB. Radical pancreaticoduodenectomy with resection and reanastomosis of the superior mesenteric vein. Surgery 30: 550–553, 1951.

    PubMed  CAS  Google Scholar 

  37. Cusack JC, Fuhrman GM, Lee JE, et al. Management of unsuspected tumor invasion of the superior mesenteric-portal venous confluence at the time of pancreaticoduodenectomy. Am J Surg 168: 352–354, 1994.

    Article  PubMed  Google Scholar 

  38. Fuhrman G, Leach SD, Staley CA, et al. Rationale for en-bloc vein resection in the treatment of pancreatic adenocarcinoma adherent to the suprerior mesenteric-portal venous confluence. Ann Surg, 223: 154–162, 1996.

    Article  PubMed  CAS  Google Scholar 

  39. Fortner JG, Kim DK, Cubilla A, et al. Regional pancreatectomy. Ann Surg 186: 42–50, 1977.

    Article  PubMed  CAS  Google Scholar 

  40. Nagakawa T, Konishi I, Veno K, et al. Surgical treatment of pancreatic cancer. The Japanese experience. Int J Pancreatol 9: 135–143, 1992.

    Google Scholar 

  41. Hertel LW, Kroin JS, Misner JW, et al. Synthesis of 2-deoxy-2′,2′ difluro-D-ribose and 2-deoxy-2′,2′dinuro-D-fibofuranosyl nucleosides. J Organ Chem 53: 2406–2409, 1988.

    Article  CAS  Google Scholar 

  42. Hertel LW, Boder GB, Kroin JS, et al. Evaluation of the antitumor activity of gemcitabine (2′,2′-difluoro-2′-deoxycytidine). Cancer Res 50: 4417–4422, 1990.

    PubMed  CAS  Google Scholar 

  43. Abbruzzese JL, Grunewald R, Weeks EA, et al. A phase I clinical, plasma and cellular pharmacology study of gemcitabine. J Clin Oncol 9: 491–498, 1991.

    PubMed  CAS  Google Scholar 

  44. Casper ES, Green MR, Kelsen DP, et al. Phase II trial of gemcitabine (2′,2′-difluorodeoxycytidine) in patietns with adenocarcinoma of the pancreas. Invest New Drugs 12: 29–34, 1994.

    Article  PubMed  CAS  Google Scholar 

  45. Moore M, Andersen J, Burris H, et al. A randomized trial of gemcitabine versus 5-FU as first-line therapy in advanced pancreatic cancer (abstr). Proc Am Soc Clin Oncol 14: 199, 1995.

    Google Scholar 

  46. Rothenberg ML, Burris HA III, Andersen JS, et al. Gemcitabine: Effective palliative therapy for pancreas cancer patients failing 5-FU (abstr). Proc Am Soci Clin Oncol 14: 198, 1995.

    Google Scholar 

  47. Johnson PJ, Corbishley TP. Sex steroid receptors and antisteroid agents in the treatment of pancreatic adenocarcinoma. Monogr Ser Eur Organ Res Treat Cancer 18: 99–104, 1987.

    Google Scholar 

  48. Greenway B, Iqbal MJ, Johnson PJ, et al. Oestrogen receptor proteins in malignant and fetal pancreas. Br Med J 283: 751–753, 1981.

    Article  CAS  Google Scholar 

  49. Iqbal MJ, Greenway BA, Wilkinson ML, et al. Sex steroid enzymes, aromatase and 5-alpha-reductase in the pancreas: A comparison of normal adult, foetal and malignant tissue. Clin Sci 65: 71, 1983.

    PubMed  CAS  Google Scholar 

  50. Greenway B, Iqbal MJ, Johnson PJ, Williams R. Low serum testosterone concentrations in patients with carcinoma of the pancreas. Br Med J 286: 93–95, 1983.

    Article  CAS  Google Scholar 

  51. Theve NO, Pousette A, Carlstrom K. Adenocarcinoma of the pancreas — a hormone sensitive tumor? A preliminary report on Nolvadex treatment. Clin Oncol 9: 193–197, 1983.

    PubMed  CAS  Google Scholar 

  52. Tonnesen K, Kamp-Jensen M. Antiestrogen therapy in pancreatic carcinoma: A preliminary report. Eur J Surg Oncol 12: 69–70, 1984.

    Google Scholar 

  53. Wong A, Chan A, Arthur K. Tamoxifen therapy in unresectable adneocarcinoma of the pancreas. Cancer Treat Rep 71: 7–14, 1987.

    Google Scholar 

  54. Taylor OM, Benson IA, McMahon MJ. Clinical trial of tamoxifen in patients with irresectable pancreatic adenocarcinoma. The Yorkshire Gastrointestinal Tumor Group. Br J Surg 80: 384–386, 1993.

    Article  PubMed  CAS  Google Scholar 

  55. Bakkevold KE, Pattersen A, Ames JB, et al. Tamoxifen therapy in unresectable adenocarcinoma of the pancreas and the papilla of Vater. Br J Surg 77: 725–730, 1990.

    Article  PubMed  CAS  Google Scholar 

  56. Keating JJ, Johnson PJ, Cochrane AM, et al. A prospective randomized trial of tamoxifen and cytoproterone acetate in pancreatic carcinoma. Br J Cancer 60: 789–792, 1989.

    Article  PubMed  CAS  Google Scholar 

  57. Zeitoun G. Hormonal therapy by somatostatin and/or LH-RH has no benefit on survival in adenocarcinoma of the pancreas (meeting abstr). Third International Conference on Neoadjuvant chemotherapy, Paris, France, Feb. 6-9, 1991; p 51.

    Google Scholar 

  58. Allegretti A, Lionetto R, Saccomanno S, et al. LH-RH analogue treatment in adenocarcinoma of the pancreas: A phase II study. Oncology 50: 77–80, 1993.

    Article  PubMed  CAS  Google Scholar 

  59. Philip PA, Carmichael J, Tonkin K, et al. Hormonal treatment of pancreatic carcinoma; a phase II study of LHRH agonist goserelin plus hydrocortisone. Br J Cancer 67: 379–382, 1993.

    Article  PubMed  CAS  Google Scholar 

  60. Swarovsky B, Wolf M, Havemann K, et al. Tamoxifen or cytoproterone acetate in combination with buserelin is ineffective in patients with pancreatic adenocarcinoma. Oncology 50: 226–229, 1993.

    Article  PubMed  CAS  Google Scholar 

  61. Abbruzzese JL, Gholson CF, Daugherty K, et al. A pilot clinical trial of the cholecystokinin receptor antagonist MK 329 in patients with advanced pancreatic cancer. Pancreas 7: 165–171, 1992.

    Article  PubMed  CAS  Google Scholar 

  62. Almoguera C, Shibata D, Forrester K, et al. Most human carcinomas of the exocrine pancreas contain mutant c-K-ras genes. Cell 53: 549–554, 1988.

    Article  PubMed  CAS  Google Scholar 

  63. Smit VT, Boot AJ, Smits AM, et al. KRAS codon 12 mutations occur very frequently in pancreatic adenocarcinomas. Nucleic Acids Res 16: 7773–7782, 1988.

    Article  PubMed  CAS  Google Scholar 

  64. Masson P, Andren-Sandberg A. Crude isolation of DNA from unselected human pancreatic tissue and amplification by the polymerase chain reaction of Ki-ras oncogene to detect point mutations in pancreatic cancer. Acta Oncol 31: 421–424, 1992.

    Article  PubMed  CAS  Google Scholar 

  65. Pellegata NS, Losekoot M, Foddie R, et al. Detection of K-ras mutations by denaturing gradient gel electrophoresis (DGGE): A study on pancreatic cancer. Anticancer Res 12: 1731–1736, 1992.

    PubMed  CAS  Google Scholar 

  66. Bos JL. Ras oncogenes in human cancer: A review. Cancer Res 49: 4682–4689, 1989.

    PubMed  CAS  Google Scholar 

  67. Pellegata NS, Sessa F, Renault B, et al. K-ras and p53 gene mutations in pancreatic cancer: Ductal and nonductal tumors progress through different genetic lesions. Cancer Res 54: 1556–1560, 1994.

    PubMed  CAS  Google Scholar 

  68. Yamada H, Sakamoto H, Taira M, et al. Amplification of both c-Ki-ras with a point mutation and c-myc in a primary pancreatic cancer and its metastatic tumors in lymph nodes. Jpn J Cancer Res 77: 370–375, 1986.

    PubMed  CAS  Google Scholar 

  69. Yamada H, Yoshida T, Sakamoto H, et al. Establishment of a human pancreatic adenocarcinoma cell line (PSW-1) with amplifications of both c-myc and activated c-Ki-ras by a point mutation. Biochem Biophys Res Commun 140: 167–170, 1986.

    Article  PubMed  CAS  Google Scholar 

  70. Horii A, Nakaturu S, Miyoshi Y, et al. Frequent somatic mutations of the APC gene in human pancreatic cancer. Cancer Res 52: 6696–6698, 1992.

    PubMed  CAS  Google Scholar 

  71. Ruggeri B, Zhang SY, Caamano J, et al. Human pancreatic carcinomas and cell lines reveal frequent and mulitple alterations in the p53 and Rb-1 tumor-suppressor genes. Oncogene 7: 1503–1511, 1992.

    PubMed  CAS  Google Scholar 

  72. Caldas C, Hahn SA, da Costa LT, et al. Frequent somatic mutations and homozygous deletions of the pl6 (MTS1) gene in pancreatic adenocarcinoma. Nature Genet 8: 27–32, 1994.

    Article  PubMed  CAS  Google Scholar 

  73. Brentnall TA, Chen R, Lee JG, et al. Microsatellite instability and K-ras mutations associated with pancreatic adenocarcinoma and pancreatitis. Cancer Res 55: 4264–4267, 1995.

    PubMed  CAS  Google Scholar 

  74. Tada M, Omata M, Kawai S, et al. Detection of ras gene mutations in pancreatic juice and peripheral blood of patients with pancreatic adenocarcinoma. Cancer Res 53: 2472–2474, 1993.

    PubMed  CAS  Google Scholar 

  75. Evans DB, Frazier ML, Charnsangavej C, et al. Molecular diagnosis of exocrine pancreatic cancer using a percutaneous technique. Ann Surg Oncol, 3: 241–246, 1996.

    Article  PubMed  CAS  Google Scholar 

  76. Abbruzzese JL, Evans DB, Larry L, et al. Molecular diagnosis of pancreatic cancer (abstr). Proc Am Soc Clin Oncol 13: 119, 1994.

    Google Scholar 

  77. Senger DR, Water LVD, Brown LF, et al. Vascular permeability factor (VPF, VEGF) in tumor biology. Cancer Metastasis Rev 12: 303–324, 1993.

    Article  PubMed  CAS  Google Scholar 

  78. Brown LF, Berse B, Jackman RW, et al. Expression of vascular permeability factor (vascular endothelial growth factor) and its receptors in adenocarcinomas of the gastrointestinal tract. Cancer Res 53: 4727–4735, 1993.

    PubMed  CAS  Google Scholar 

  79. Takahashi Y, Kitadai Y, Bucana CD, et al. Expression of vascular endothelial growth factor and its receptor, KDR, correlates with vascularity, metastasis, and proliferation of human colon cancer. Cancer Res 55: 3964–3968, 1995.

    PubMed  CAS  Google Scholar 

  80. Egawa S, Tsutsumi M, Konishi Y, et al. The role of angiogenesis in the tumor growth of Syrian hamster pancreatic cancer cell line HPD-NR. Gastroenterology 108: 1526–1533, 1995.

    Article  PubMed  CAS  Google Scholar 

  81. Rak J, Mitsuhashi Y, Bayko L. Mutant ras oncogenes upregulate VEGF/VPF expression: Implications for induction and inhibition of tumor angiogenesis. Cancer Res 55: 4575–4580, 1995.

    PubMed  CAS  Google Scholar 

  82. Bours V, Dejardin E, Goujon-Letawe F, Merville M, Castronovo V. The NF-kB transcription factor and cancer: High expression of NF-kB-and IkB-related proteins in tumor cell lines. Biochem Pharmacol 47: 145–149, 1994.

    Article  PubMed  CAS  Google Scholar 

  83. Grilli M, Chiu JJ-S, Lenardo MJ. NF-kB and Rel: Participants in a multiform transcriptional regulatory system. Int Rev Cytol 143: 1–62, 1993.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Douglas B. Evans
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  2. Jeffrey E. Lee
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  3. Peter W. T. Pisters
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  4. Chusilp Charnsangavej
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  5. Lee M. Ellis
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  6. Paul J. Chiao
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  7. Renato Lenzi
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  8. James L. Abbruzzese
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Editors and Affiliations

  1. M.D. Anderson Cancer Center, The University of Texas, Houston, Texas, USA

    Raphael E Pollock M.D., Ph.D.

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Evans, D.B. et al. (1997). Advances in the diagnosis and treatment of adenocarcinoma of the pancreas. In: Pollock, R.E. (eds) Surgical Oncology. Cancer Treatment and Research, vol 90. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-6165-1_6

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  • DOI: https://doi.org/10.1007/978-1-4615-6165-1_6

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