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Erschienen in: Der Chirurg 4/2018

20.12.2017 | Pankreaskarzinom | Leitthema

Pankreasfrühkarzinom

verfasst von: C. Kahlert, M. Distler, D. Aust, L. Gieldon, J. Weitz, Prof. Dr. T. Welsch

Erschienen in: Die Chirurgie | Ausgabe 4/2018

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Zusammenfassung

Hintergrund

Das Pankreaskarzinom steht bei den tumorbedingten Todesursachen aktuell an vierter Stelle und wird bis 2020 voraussichtlich die zweithäufigste Todesursache in den USA sein.

Fragestellung

Welche Diagnosemöglichkeiten und Therapiestrategien zur Behandlung eines Pankreasfrühkarzinoms und seiner präkanzerösen Vorstufen können angewandt werden?

Ergebnisse

Eine flächendeckende Vorsorgeuntersuchung ist zur Früherkennung beim Pankreaskarzinom in der Normalbevölkerung nicht sinnvoll. Beim Verdacht auf auf das Vorliegen eines familiären Pankreaskarzinoms oder bei nachgewiesenen sporadischen Keimbahnmutationen mit erhöhtem Erkrankungsrisiko sollte hingegen eine Vorsorgeuntersuchung spätestens ab dem 45. Lebensjahr begonnen werden. Ebenfalls sollte bei Patienten mit einer präkanzerösen Pankreasneoplasie (insbesondere muzinöse Pankreastumoren) eine elektive Pankreas(teil)resektion durchgeführt werden, da hier ein relevantes Risiko für das Vorliegen eines Pankreasfrühkarzinoms besteht. Komplementär zur bildgebenden Diagnostik können möglicherweise zukünftig nichtinvasive, blutbasierte Biomarker wie zirkulierende Tumorzellen, Exosome oder zellfreie Tumor-DNA eingesetzt werden, um ein Pankreaskarzinom bereits im Frühstadium erkennen zu können.

Schlussfolgerung

Die rechtzeitige Diagnose und Behandlung eines Pankreasfrühkarzinoms kann die Prognose der betroffenen Patienten deutlich verbessern.
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Metadaten
Titel
Pankreasfrühkarzinom
verfasst von
C. Kahlert
M. Distler
D. Aust
L. Gieldon
J. Weitz
Prof. Dr. T. Welsch
Publikationsdatum
20.12.2017
Verlag
Springer Medizin
Erschienen in
Die Chirurgie / Ausgabe 4/2018
Print ISSN: 2731-6971
Elektronische ISSN: 2731-698X
DOI
https://doi.org/10.1007/s00104-017-0569-y

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