Archive for the ‘Pancreatic cancer’ Category


Pancreatic cancer: CONCLUSIONS

Aug 3, 2012 Author: Walter Mcneil | Filed under: Pancreatic cancer

CONCLUSIONS

Surgical resection affords a significant survival benefit for patients with UICC stage I and II pancreatic cancer. The main goal of surgery is to achieve an oncological R0 resection. This R0 resection must include distant tissues, such as the perivascular nerves, extrapancreatic ganglia, lymph tissue in the hepatoduodenal ligament and lymph nodes in the paramesenteric location. We recommend adjuvant chemotherapy for all patients after surgical resection. Uncontrolled prospective trials have shown a five-year survival in one-third of patients following R0 resection combined with adjuvant chemotherapy. A small group of patients with UICC stage III cancer may benefit from neoadjuvant radiochemotherapy. In advanced pancreatic cancer, palliative chemotherapy (consisting of 5-fluoro-uracil plus folinic acid) is still the treatment of choice. Newer drugs, such as gemcitabine, seem to offer slightly better short term survival. Most advantageous shopping – buy glucophage for everyone to spend less.

Pancreatic cancer: INDICATIONS AND LIMITS OF SURGERY Part 2

Jul 29, 2012 Author: Walter Mcneil | Filed under: Pancreatic cancer

Resection is more frequently undertaken in centres that see large numbers of patients with pancreatic cancer. Nevertheless, the long term survival is determined by the biology of the disease. Five-year survival rates range from 3% to 24%, but rarely exceed 10% in large collective series. The median survival time is usually between 12.8 and 15.8 months after surgery (Table 4). Your drugs could cost you less – diabetes drugs to start the treatment soon.

TABLE 4
Surgical options for pancreatic adenocarcinoma

Approach Achievable result
Increase in resection rate > 25%
Increase in achieving an R0 resection > 50%
Decrease in hospital mortality after resection < 5%
Increase in survival after oncological 2 year > 40%
R0 resection 5 year > 25%
Extended operative tissue clearance of N1 and N2 lymph nodes, and perivascular and retroperitoneal tissue Prolonged individual survival
Portal and superior mesenteric vein resection in V1- and V2-positive patients, without circumferential involvement of the vein Prolonged individual survival
Selective use of PPPD Reduced early and late morbidity

N1 Metastasis to group 1 lymph nodes according to the classification of the Japan Pancreas Society; N2 Metastasis to group 2 lymph nodes; PPPD Pylorus-preserving pancreatoduodenectomy; V1 Suspected venous invasion; V2 Definite venous invasion

(more…)

Pancreatic cancer: ADJUVANT CHEMOTHERAPY

May 6, 2012 Author: Walter Mcneil | Filed under: Pancreatic cancer

ADJUVANT CHEMOTHERAPY

Even UICC stage I cancers are usually not limited to the pancreas when methods of molecular biology are employed to examine cancer cell dissemination. Such techniques have demonstrated infiltration with cancer cells in 50% of lymph nodes that are histologically negative for cancer. After ostensibly curative resection, cancer recurs locally in 70% to 90% of cases, usually in the liver or the peritoneal cavity, which has led to an increased interest in adjuvant or multimodal therapy. Because resection alone results in insufficient disease control, adjuvant chemotherapy, and combined radiation and chemotherapy have been attempted.

(more…)

Pancreatic cancer: LOCAL OR EXTENDED LYMPH NODE DISSECTION?

May 3, 2012 Author: Walter Mcneil | Filed under: Pancreatic cancer

Pancreatic cancer

No definite conclusions can be drawn about the effectiveness of extended lymph node dissection from the available evidence. Even though many centres have adopted the practice of radical lymph node resection, there is still residual disease. Compared with standard resection, this technique has extended survival, even in patients with advanced cancer (UICC stage III), but median survival rates still do not exceed 12 to 20 months.

(more…)

Pancreatic cancer: INDICATIONS AND LIMITS OF SURGERY Part 1

Apr 30, 2012 Author: Walter Mcneil | Filed under: Pancreatic cancer

While surgical resection of the tumour-bearing pancreas along with clearance of adjacent tissues offers the best chance for cure, only 10% to 25% of patients have resectable disease at the time of diagnosis (Table 2). Even in so-called oncological R0 resections, cure is not always possible. Therefore, surgical therapy of pancreatic cancer is limited. Multimodal therapy, either surgery combined with adjuvant therapy or palliative multimodal treatment, is required in almost every case (Table 3). Buy cheap drugs online fast – buy antibiotics online for you to enjoy a reliable pharmacy.

(more…)

Pancreatic cancer: TUMOUR-RELATED PROGNOSTIC FACTORS

Apr 28, 2012 Author: Walter Mcneil | Filed under: Pancreatic cancer

On the basis of knowledge about tumour growth in pancreatic cancer, several factors that favourably influence the prognosis have been identified. These factors include a tumour size of less than 2 cm in diameter, absence of lymph node metastases, lack of involvement of vessel walls and lack of nerve involvement (Table 1). Cheapest medications online – buy yasmin online for you to get healthy very soon.

TABLE 1
Favourable prognostic factors for pancreatic cancer

Factor Author, year (reference)
Tumour size less than 2 to 3 cm Tsuchiya et al, 1985 (7)
Negative for lymph node involvement Cameron et al, 1991 (1)
Negative for nerve infiltration Nagakawa et al, 1991 (6)
Negative for vascular wall infiltration Ishikawa et al, 1988 (14)
Well-differentiated cells Geer and Brennan, 1993 (2)
Diploid DNA Yeo et al, 1995 (15)
Cancer genes: Wild-type of p53, p16, DPC4 Rozenblum and Kern, 1997 (16)

(more…)

Pancreatic cancer: Who benefits from curative resection?

Apr 26, 2012 Author: Walter Mcneil | Filed under: Pancreatic cancer

Pancreatic cancer

Pancreatic cancer is a highly malignant disease, and the mortality rates are nearly as high as the incidence rates. The annual incidence is 10,500 in Germany and 27,000 in the United States. The two-year survival rate is only 5% to 10%. The incidence increases after age 30 years, and the peak mortality occurs between ages 65 and 72 years in Europe, and between ages 55 and 75 years in the United States. You can find best quality treatment now – buy birth control online to see how cheap it is.

Sites of disease dissemination include lymphatic channels and regional lymph nodes, retropancreatic tissues, bile duct, duodenum, liver, peritoneum, local vascular invasion and extrapancreatic nerve plexus. Isolated dormant tumour cells can be found in the bone marrow and liver at the time of diagnosis in 20% to 60% of patients. Invasion of the common bile duct, duodenum, liver, and local and distant parts of the peritoneum occur early in this disease. Free tumour cells are detected in the peritoneum at the time of surgery in one-third of patients.

(more…)

Categories


Advertising


Most Popular

  • None found

Recent Comments

  • None found