nach oben

Indian Journal of Surgery

Erschienen in:

01.08.2021 | Original Article

Update on Management Periampullary/Pancreatic Head Cancer

verfasst von: Mallika Tewari, Jyoti R. Swain, R. Mahendran

Erschienen in: Indian Journal of Surgery | Sonderheft 3/2021

Einloggen, um Zugang zu erhalten

Abstract

Management of pancreatic head (ductal adenocarcinoma) and periampullary cancer is difficult owing to its insidious onset and hence late diagnosis, lack of significant diagnostic, predictive and prognostic biomarkers, and the inherent tumor biology of being relatively resistant to chemotherapy and radiotherapy. Surgery of this deep-seated gland is technically challenging and the procedure is called pancreaticoduodenectomy (PD). It involves removal of pancreatic head, duodenum, bile duct and gallbladder ± distal stomach. The reconstruction involves pancreatoenteric anastomosis (pancreaticojejunostomy or pancreaticogastrostomy), hepaticojejunostomy, and gastro/duodenojejunostomy. At times, vascular resection and adjacent organ resection are required for complete extirpation (R0) of the cancer. Over the years, surgical procedures used in the management of pancreatic cancer (PC) have been refined and with better anesthesia and perioperative and postoperative care, the operative mortality has dropped to < 5% but morbidity still remains close to 40%. The most common cause of severe morbidity is occurrence of postoperative pancreatic fistula. Post pancreatectomy hemorrhage and delayed gastric emptying are the other two major morbidities extending hospital stay and are at times life-threatening. New classification systems, better imaging, and new chemotherapeutic/targeted drug combinations for neoadjuvant/adjuvant treatment with/without refined radiotherapy techniques and centralization of treatment have helped in selecting the best patients for aggressive treatment with the aim of improving abysmally low overall survival. The present review highlights recent updates in the management of PC.

Venkatesh B, Anand L, Padamavathi VK, Balachandar V (2016) Review on clinical and molecular diagnosis of periampullary carcinoma. Int J Adv Res Biol Sci 3(9):210–216CrossRef

Canto MI, Harinck F, Hruban RH, Offerhaus GJ, Poley JW, Kamel I, Nio Y, Schulick RS, Bassi C, Kluijt I, Levy MJ, Chak A, Fockens P, Goggins M, Bruno M, International Cancer of Pancreas Screening (CAPS) Consortium (2013) International Cancer of the Pancreas Screening (CAPS) Consortium summit on the management of patients with increased risk for familial pancreatic cancer. Gut 62(3):339–347. https://doi.org/10.1136/gutjnl-2012-303108CrossRefPubMed

Schultz NA, Dehlendorff C, Jensen BV, Bjerregaard JK, Nielsen KR, Bojesen SE, Calatayud D, Nielsen SE, Yilmaz M, Holländer NH, Andersen KK, Johansen JS (2014) MicroRNA biomarkers in whole blood for detection of pancreatic cancer. Jama 311:392–404PubMedCrossRef

Liggett T, Melnikov A, Yi QL et al (2010) Differential methylation of cell- free circulating DNA among patients with pancreatic cancer versus chronic pancreatitis. Cancer 116:1674–1680PubMedCrossRef

Tewari M (2015) Pancreatic cancer: a challenge to cure, Indian J Surg. 77(5):350–357. https://doi.org/10.1007/s12262-015-1369-6

O'Brien DP, Sandanayake NS, Jenkinson C, Gentry-Maharaj A, Apostolidou S, Fourkala EO, Camuzeaux S, Blyuss O, Gunu R, Dawnay A, Zaikin A, Smith RC, Jacobs IJ, Menon U, Costello E, Pereira SP, Timms JF (2015) Serum CA19-9 is significantly upregulated up to 2 years before diagnosis with pancreatic cancer: implications for early disease detection. Clin Cancer Res 21(3):622–631. https://doi.org/10.1158/1078-0432.CCR-14-0365CrossRefPubMed

Verma A, Shukla S, Verma N (2015) Diagnosis, preoperative evaluation, and assessment of resectability of pancreatic and periampullary cancer. Indian J Surg 77(5):362–370PubMedPubMedCentralCrossRef

De Angelis C, Brizzi RF, Pellicano R (2013) Endoscopic ultrasonography for pancreatic cancer: current and future perspectives. J Gastrointest Oncol 4(2):220–230PubMedPubMedCentral

Callery MP, Chang KJ, Fishman EK, Talamonti MS, William Traverso L, Linehan DC (2009) Pretreatment assessment of resectable and borderline resectable pancreatic cancer: expert consensus statement. Ann Surg Oncol 16(7):1727–1733PubMedCrossRef

10.

Varadhachary GR (2011) Preoperative therapies for resectable and borderline resectable pancreatic cancer. J Gastrointest Oncol 2(3):136–142PubMedPubMedCentral

11.

National Comprehensive Cancer Network (NCCN) v2. 2017

12.

Katz MH, Marsh R, Herman JM, Shi Q, Collison E, Venook AP, Kindler HL, Alberts SR, Philip P, Lowy AM, Pisters PW, Posner MC, Berlin JD, Ahmad SA (2013) Borderline resectable pancreatic cancer: need for standardization and methods for optimal clinical trial design. Ann Surg Oncol 20(8):2787–2795PubMedPubMedCentralCrossRef

13.

Allen VB, Gurusamy KS, Takwoingi Y, Kalia A, Davidson BR (2016) Diagnostic accuracy of laparoscopy following computed tomography (CT) scanning for assessing the resectability with curative intent in pancreatic and periampullary cancer. Cochrane Database Syst Rev 7:CD009323. https://doi.org/10.1002/14651858.CD009323.pub3CrossRefPubMed

14.

Chun YS, Pawlik TM, Vauthey JN (2017) 8th edition of the AJCC Cancer staging manual: pancreas and hepatobiliary cancers. Ann Surg Oncol. https://doi.org/10.1245/s10434-017-6025-x

15.

Allen PJ, Kuk D, Castillo CF, Basturk O, Wolfgang CL, Cameron JL, Lillemoe KD, Ferrone CR, Morales-Oyarvide V, He J, Weiss MJ, Hruban RH, Gönen M, Klimstra DS, Mino-Kenudson M (2017) Multi-institutional validation study of the American Joint Commission on Cancer (8th edition) changes for T and N staging in patients with pancreatic adenocarcinoma. Ann Surg 265(1):185–191PubMedCrossRef

16.

Layfield LJ, Dodd L, Factor R, Schmidt RL (2014) Malignancy risk associated with diagnostic categories defined by the Papanicolaou Society of Cytopathology pancreaticobiliary guidelines. Cancer Cytopathol 122:420–427PubMedCrossRef

17.

Lai EC, Lau SH, Lau WY (2014) The current status of preoperative biliary drainage for patients who receive pancreaticoduodenectomy for periampullary carcinoma: a comprehensive review. Surgeon 12(5):290–296PubMedCrossRef

18.

van der Gaag NA, Rauws EAJ, van Eijck CHJ, Bruno MJ, van der Harst E, Kubben FJGM, Gerritsen JJGM, Greve JW, Gerhards MF, de Hingh IHJT, Klinkenbijl JH, Nio CY, de Castro SMM, Busch ORC, van Gulik TM, Bossuyt PMM, Gouma DJ (2010) Preoperative biliary drainage for cancer of the head of the pancreas. N Engl J Med 362:129–137PubMedCrossRef

19.

Codivilla A (1898) Rendiconto statistico della sezione chirurgica dell’ospedale di lmola

20.

Sauve L (1908) Des pancréatectomies et spécialement de la pancreatectomy céphalique. Rev Chir 37:113–152 335–85

21.

Kawai M, Yamaue H (2010) Analysis of clinical trials evaluating complications after pancreaticoduodenectomy: a new era of pancreatic surgery. Surg Today 40:1011–1017PubMedCrossRef

22.

Winter JW, Cameron JL, Campbell KA, Arnold MA, Chang DC, Coleman J et al (2006) 1423 pancreaticoduodenectomies for pancreatic cancer: a single-institution experience. J Gastrointest Surg 10:1199–1211PubMedCrossRef

23.

Muller MW, Friess H, Beger HG, Kleeff J, Lauterburg B, Glasbrenner B, Riepl RL, Buchler MW (1997) Gastric emptying following pylorus-preserving Whipple and duodenum-preserving pancreatic head resection in patients with chronic pancreatitis. Am J Surg 173(4):257–263. https://doi.org/10.1016/S0002-9610(96)00402-3CrossRefPubMed

24.

van Berge Henegouwen MI, van Gulik TM, DeWit LT, Allema JH, Rauws EA, Obertop H, Gouma DJ (1997) Delayed gastric emptying after standard pancreaticoduodenectomy versus pylorus-preserving pancreaticoduodenectomy: an analysis of 200 consecutive patients. J Am Coll Surg 185(4):373–379PubMedCrossRef

25.

Jimenez RE, Fernandez-del Castillo C, Rattner DW, Chang Y, Warshaw AL (2000) Outcome of pancreaticoduodenectomy with pylorus preservation or with antrectomy in the treatment of chronic pancreatitis. Ann Surg 231(3):293–300PubMedPubMedCentralCrossRef

26.

Balcom JH, Rattner DW, Warshaw AL, Chang Y, Fernandez-del Castillo C (2001) Ten-year experience with 733 pancreatic resec- tions: changing indications, older patients, and decreasing length of hospitalization. Arch Surg 136(4):391–398PubMedCrossRef

27.

Sadowski CUW, Baer HU, Reber P, Seiler C, Büchler M (1997) Delayed gastric emptying after classic and pylorus-preserving Whipple procedure: a prospective study. Dig Surg 14:159–164CrossRef

28.

Horstmann O, Becker H, Post S, Nustede R (1999) Is delayed gastric emptying following pancreaticoduodenectomy related to pylorus preservation? Langenbecks Arch Surg / Deutsch Gesellschaft Chir 384(4):354–359CrossRef

29.

Niedergethmann M, Shang E, Farag Soliman M, Saar J, Berisha S, Willeke F, Post S (2006) Early and enduring nutritional and functional results of pylorus preservation vs classic Whipple procedure for pancreatic cancer. Langenbecks Arch Surg / Deutsch Gesellschaft Chir 391(3):195–202. https://doi.org/10.1007/s00423-005-0015-3

30.

Kawai M, Tani M, Hirono S, Miyazawa M, Shimizu A, Uchiyama K, Yamaue H (2011) Pylorus ring resection reduces delayed gastric emptying in patients undergoing pancreatoduodenectomy: a prospective, randomized, controlled trial of pylorus-resecting versus pylorus-preserving pancreatoduodenectomy. Ann Surg 253(3):495–501. https://doi.org/10.1097/SLA.0b013e31820d98f1CrossRefPubMed

31.

Kurahara H, Shinchi H, Maemura K, Mataki Y, Iino S, Sakoda M, Ueno S, Takao S, Natsugoe S (2011) Delayed gastric emptying after pancreatoduodenectomy. J Surg Res 171(2):e187–e192. https://doi.org/10.1016/j.jss.2011.08.002CrossRefPubMed

32.

Hayashibe A, Kameyama M, Shinbo M, Makimoto S (2007) The surgical procedure and clinical results of subtotal stomach preserving pancreaticoduodenectomy (SSPPD) in comparison with pylorus preserving pancreaticoduodenectomy (PPPD). J Surg Oncol 95(2):106–109PubMedCrossRef

33.

Matsumoto I, Shinzeki M, Asari S, Goto T, Shirakawa S, Ajiki T, Fukumoto T, Suzuki Y, Ku Y (2014) A prospective randomized comparison between pylorus- and subtotal stomach-preserving pancreatoduodenectomy on postoperative delayed gastric emptying occurrence and long-term nutritional status. J Surg Oncol 109(7):690–696PubMedCrossRef

34.

Hartwig W, Hackert T, Hinz U, Hassenpflug M, Strobel O, Bùchler MW et al (2009) Multivisceral resection for pancreatic malignancies: risk-analysis and long-term outcome. Ann Surg 250:81–87PubMedCrossRef

35.

Burdelski CM, Reeh M, Bogoevski D, Gebauer F, Tachezy M, Vashist YK, Cataldegirmen G, Yekebas E, Izbicki JR, Bockhorn M (2011) Multivisceral resections in pancreatic cancer: identification of risk factors. World J Surg 35:2756–2763PubMedCrossRef

36.

Hartwig W, Gluth A, Hinz U, Koliogiannis D, Strobel O, Hackert T, Werner J, Büchler MW (2016) Outcomes after extended pancreatectomy in patients with borderline resectable and locally advanced pancreatic cancer. Br J Surg 103(12):1683–1694. https://doi.org/10.1002/bjs.10221CrossRefPubMed

37.

Tewari M (2016) Significance of pathological positive superior mesenteric/portal venous invasion in pancreatic cancer. Hepatobiliary Pancreat Dis Int 15(6):572–578PubMedCrossRef

38.

Thilo Hackert T, Schneider L, Büchler MW (2015) Current state of vascular resections in pancreatic cancer surgery. Gastroenterol Res Pract 2015:120207. https://doi.org/10.1155/2015/120207CrossRefPubMedPubMedCentral

39.

Duffas JP, Suc B, Msika S, Fourtanier G, Muscari F, Hay JM et al (2005) A controlled randomized multicenter trial of pancreatogastrostomy or pancreatojejunostomy after pancreatoduodenectomy. Am J Surg 189:720–729PubMedCrossRef

40.

Bassi C, Falconi M, Molinari E, Salvia R, Butturini G, Sartori N et al (2005) Reconstruction by pancreaticojejunostomy versus pancreaticogastrostomy following pancreatectomy. Results of a comparative study. Ann Surg 242:767–773PubMedPubMedCentralCrossRef

41.

Fernandez-Cruz L, Cosa R, Blanco L, Lopez-Boado MA, Astudillo E (2008) Pancreatogastrostomy with gastric partition after pylorus-preserving pancreatoduodenectomy versus conventional pancreatojejunostomy: a prospective randomized study. Ann Surg 248:930–938PubMedCrossRef

42.

Topal B, Fieuws S, Aerts R, Weerts J, Feryn T, Roeyen G, Bertrand C, Hubert C, Janssens M, Closset J, Belgian Section of Hepatobiliary and Pancreatic Surgery (2013) Pancreaticojejunostomy versus pancreaticogastrostomy reconstruction after pancreaticoduodenectomy for pancreatic or periampullary tumours: a multicentre randomised trial. Lancet Oncol 14:655–662PubMedCrossRef

43.

Figueras J, Sabater L, Planellas P, Muñoz-Forner E, Lopez-Ben S, Falgueras L, Sala-Palau C, Albiol M, Ortega-Serrano J, Castro-Gutierrez E (2013) Randomized clinical trial of pancreaticogastrostomy versus pancreaticojejunostomy on the rate and severity of pancreatic fistula after pancreaticoduodenectomy. Br J Surg 100:1597–1605PubMedCrossRef

44.

El Nakeeb A, Hamdy E, Sultan AM et al (2014) Isolated roux loop pancreaticojejunostomy versus pancreaticogastrostomy after pancreaticoduodenectomy: a prospective randomized study. HPB (Oxford) 16:713–722CrossRef

45.

Tewari M, Hazrah P, Kumar V, Shukla HS (2010) Options of restorative pancreaticoenteric anastomosis following pancreaticoduodenectomy: a review. Surg Oncol 19(1):17–26PubMedCrossRef

46.

Cheng Y, Briarava M, Lai M, Wang X, Tu B, Cheng N, Gong J, Yuan Y, Pilati P, Mocellin S (2017) Pancreaticojejunostomy versus pancreaticogastrostomy reconstruction for the prevention of postoperative pancreatic fistula following pancreaticoduodenectomy. Cochrane Database Syst Rev 9:CD012257. https://doi.org/10.1002/14651858.CD012257.pub2CrossRefPubMed

47.

Zhao Z, Yin Z, Hang Z, Ji G, Feng Q, Zhao Q (2017) A systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy. Sci Rep 7(1):2220. https://doi.org/10.1038/s41598-017-02488-4CrossRefPubMedPubMedCentral

48.

Ricci C, Casadei R, Taffurelli G, Pacilio CA, Ricciardiello M, Minni F (2017) Minimally invasive pancreaticoduodenectomy: what is the best “choice”? A systematic review and network meta-analysis of non-randomized comparative studies. World J Surg. https://doi.org/10.1007/s00268-017-4180-7

49.

Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, Neoptolemos J, Sarr M, Traverso W, Buchler M, International Study Group on Pancreatic Fistula Definition (2005) Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 138:8–13PubMedCrossRef

50.

Wente MN, Bassi C, Dervenis C, Fingerhut A, Gouma DJ, Izbicki JR, Neoptolemos JP, Padbury RT, Sarr MG, Traverso LW, Yeo CJ, Büchler MW (2007) Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery 142(5):761–768PubMedCrossRef

51.

Wente MN, Veit JA, Bassi C, Dervenis C, Fingerhut A, Gouma DJ, Izbicki JR, Neoptolemos JP, Padbury RT, Sarr MG, Yeo CJ, Büchler MW (2007) Postpancreatectomy hemorrhage (PPH): an International Study Group of Pancreatic Surgery (ISGPS) definition. Surgery.;142(1):20–5

52.

Tol JA, Gouma DJ, Bassi C, Dervenis C, Montorsi M, Adham M, Andrén-Sandberg A, Asbun HJ, Bockhorn M, Büchler MW, Conlon KC, Fernández-Cruz L, Fingerhut A, Friess H, Hartwig W, Izbicki JR, Lillemoe KD, Milicevic MN, Neoptolemos JP, Shrikhande SV, Vollmer CM, Yeo CJ, Charnley RM, International Study Group on Pancreatic Surgery (2014) Definition of a standard lymphadenectomy in surgery for pancreatic ductal adenocarcinoma: a consensus statement by the International Study Group on Pancreatic Surgery (ISGPS). Surgery 156(3):591–600. https://doi.org/10.1016/j.surg.2014.06.016CrossRefPubMed

53.

Hartwig W, Vollmer CM, Fingerhut A, Yeo CJ, Neoptolemos JP, Adham M, Andrén-Sandberg A, Asbun HJ, Bassi C, Bockhorn M, Charnley R, Conlon KC, Dervenis C, Fernandez-Cruz L, Friess H, Gouma DJ, Imrie CW, Lillemoe KD, Milićević MN, Montorsi M, Shrikhande SV, Vashist YK, Izbicki JR, Büchler MW, International Study Group on Pancreatic Surgery (2014) Extended pancreatectomy in pancreatic ductal adenocarcinoma: definition and consensus of the International Study Group for Pancreatic Surgery (ISGPS). Surgery 156(1):1–14. https://doi.org/10.1016/j.surg.2014.02.009CrossRefPubMed

54.

Bockhorn M, Uzunoglu FG, Adham M, Imrie C, Milicevic M, Sandberg AA, Asbun HJ, Bassi C, Büchler M, Charnley RM, Conlon K, Cruz LF, Dervenis C, Fingerhutt A, Friess H, Gouma DJ, Hartwig W, Lillemoe KD, Montorsi M, Neoptolemos JP, Shrikhande SV, Takaori K, Traverso W, Vashist YK, Vollmer C, Yeo CJ, Izbicki JR, International Study Group of Pancreatic Surgery (2014) Borderline resectable pancreatic cancer: a consensus statement by the International Study Group of Pancreatic Surgery (ISGPS). Surgery 155(6):977–988. https://doi.org/10.1016/j.surg.2014.02.001CrossRefPubMed

55.

Bassi C, Marchegiani G, Dervenis C, Sarr M, Abu Hilal M, Adham M, Allen P, Andersson R, Asbun HJ, Besselink MG, Conlon K, Del Chiaro M, Falconi M, Fernandez-Cruz L, Fernandez-Del Castillo C, Fingerhut A, Friess H, Gouma DJ, Hackert T, Izbicki J, Lillemoe KD, Neoptolemos JP, Olah A, Schulick R, Shrikhande SV, Takada T, Takaori K, Traverso W, Vollmer CR, Wolfgang CL, Yeo CJ, Salvia R, Buchler M, International Study Group on Pancreatic Surgery (ISGPS) (2017) The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 years after. Surgery 161(3):584–591. https://doi.org/10.1016/j.surg.2016.11.014CrossRefPubMed

56.

Shrikhande SV, Sivasanker M, Vollmer CM, Friess H, Besselink MG, Fingerhut A et al (2016) Pancreatic anastomosis after pancreatoduodenectomy: a position statement by the International Study Group of Pancreatic Surgery (ISGPS). Surgery 161(5):1221–1234. https://doi.org/10.1016/j.surg.2016.11.021CrossRefPubMed

57.

Jin K, Zhou H, Zhang J, Wang W, Sun Y, Ruan C, Hu Z, Wang Y (2015) Systematic review and meta-analysis of somatostatin analogues in the prevention of postoperative complication after pancreaticoduodenectomy. Dig Surg 32(3):196–207PubMedCrossRef

58.

Kehlet H, Wilmore DW (2002) Multimodal strategies to improve surgical outcome. Am J Surg 183:630–641PubMedCrossRef

59.

Lassen K, Soop M, Nygren J, Cox PB, Hendry PO, Spies C, von Meyenfeldt M, Fearon KC, Revhaug A, Norderval S, Ljungqvist O, Lobo DN, Dejong CH, Enhanced Recovery After Surgery (ERAS) Group (2009) Consensus review of optimal perioperative care in colorectal surgery: Enhanced Recovery After Surgery (ERAS) Group recommendations. Arch Surg 144:961–969PubMedCrossRef

60.

Xiong J, Szatmary P, Huang W, de la Iglesia-Garcia D, Nunes QM, Xia Q, Hu W, Sutton R, Liu X, Raraty MG (2016) Enhanced recovery after surgery program in patients undergoing pancreaticoduodenectomy: a PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 95(18):e3497. https://doi.org/10.1097/MD.0000000000003497CrossRef

61.

Griffin JF, Smalley SR, Jewell W, Paradelo JC, Reymond RD, Hassanein RE, Evans RG (1990) Patterns of failure after curative resection of pancreatic carcinoma. Cancer 66:56–61. https://doi.org/10.1002/1097-0142(19900701)66CrossRefPubMed

62.

Sohn TA, Yeo CJ, Cameron JL, Koniaris L, Kaushal S, Abrams RA, Sauter PK, Coleman J, Hruban RH, Lillemoe KD (2000) Resected adenocarcinoma of the pancreas-616 patients: results, outcomes, and prognostic indicators. J Gastrointest Surg 4(6):567–579PubMedCrossRef

63.

Klinkenbijl JH, Jeekel J, Sahmoud T, van Pel R, Couvreur ML, Veenhof CH, Arnaud JP, Gonzalez DG, de Wit LT, HennipmanA WJ (1999) Adjuvant radiotherapy and 5-fluorouracil after curative resection of cancer of the pancreas and periampullary region: phase III trial of the EORTC gastrointestinal tract cancer cooperative group. Ann Surg 230:776–782; discussion 782-4. https://doi.org/10.1097/00000658-199912000-00006CrossRefPubMedPubMedCentral

64.

Spitz FR, Abbruzzese JL, Lee JE, Pisters PW, Lowy AM, FenoglioCJ CKR, Janjan NA, Goswitz MS, Rich TA, Evans DB (1997) Preoperative and postoperative chemoradiation strategies in patients treated with pancreaticoduodenectomy for adenocarcinoma of the pancreas. J Clin Oncol 15:928–937PubMedCrossRef

65.

Ohigashi H, Ishikawa O, Eguchi H, Takahashi H, GotohK YT, Yano M, Nakaizumi A, Uehara H, Tomita Y, Nishiyama K (2009) Feasibility and efficacy of combination therapy with preoperative full-dose gemcitabine, concurrent three-dimensional conformal radiation, surgery, and postoperative liver perfusion chemotherapy for T3-pancreatic cancer. Ann Surg 250:88–95. https://doi.org/10.1097/SLA.0b013e3181ad65ccCrossRefPubMed

66.

Palmer DH, Stocken DD, Hewitt H, Markham CE, Hassan AB, Johnson PJ, Buckels JA, Bramhall SR (2007) A randomized phase 2 trial of neoadjuvant chemotherapy in resectable pancreatic cancer: gemcitabine alone versus gemcitabine combined with cisplatin. Ann Surg Oncol 14:2088–2096PubMedCrossRef

67.

Heinrich S, Schäfer M, Weber A, Hany TF, Bhure U, Pestalozzi BC, Clavien PA (2008) Neoadjuvant chemotherapy generates a significant tumor response in resectable pancreatic cancer without increasing morbidity: results of a prospective phase II trial. Ann Surg 248:1014–1022. https://doi.org/10.1097/SLA.0b013e318190a6da

68.

Stokes JB, Nolan NJ, Stelow EB, Walters DM, Weiss GR, de Lange EE, Rich TA, Adams RB, Bauer TW (2011) Preoperative capecitabine and concurrent radiation for borderline resectable pancreatic cancer. Ann Surg Oncol 18(3):619–627. https://doi.org/10.1245/s10434-010-1456-7CrossRefPubMed

69.

Yang A, O’Reilly EM (2015) Novel directions in neoadjuvant therapy for pancreas adenocarcinoma. Expert Rev Gastroenterol Hepatol 9:585–601

70.

Gillen S, Schuster T, Meyer Zum Büschenfelde C, Friess H, Kleeff J (2010) Preoperative/neoadjuvant therapy in pancreatic cancer: a systematic review and meta-analysis of response and resection percentages. PLoS Med 7(4):e1000267PubMedPubMedCentralCrossRef

71.

Katz MH, Shi Q, Ahmad SA, Herman JM, Marsh Rde W, Collisson E, Schwartz L, Frankel W, Martin R, Conway W, Truty M, Kindler H, Lowy AM, Bekaii-Saab T, Philip P, Talamonti M, Cardin D, LoConte N, Shen P, Hoffman JP, Venook AP (2016) Preoperative Modified FOLFIRINOX treatment followed by capecitabine-based chemoradiation for borderline resectable pancreatic cancer: Alliance for Clinical Trials in Oncology Trial A021101. JAMA Surg 151(8):e161137. https://doi.org/10.1001/jamasurg.2016.1137CrossRefPubMedPubMedCentral

72.

Katz MH, Fleming JB, Bhosale P, Varadhachary G, Lee JE, Wolff R, Wang H, Abbruzzese J, Pisters PW, Vauthey JN, Charnsangavej C, Tamm E, Crane CH, Balachandran A (2012) Response of borderline resectable pancreatic cancer to neoadjuvant therapy is not reflected by radiographic indicators. Cancer 118(23):5749–5756. https://doi.org/10.1002/cncr.27636CrossRefPubMed

73.

Katz MHG, Ou FS, Herman JM, Ahmad SA, Wolpin B, Marsh R, Behr S, Shi Q, Chuong M, Schwartz LH, Frankel W, Collisson E, Koay EJ, Hubbard JM, Leenstra JL, Meyerhardt J, O'Reilly E (2017) Alliance for clinical trials in oncology (ALLIANCE) trial A021501: preoperative extended chemotherapy vs. chemotherapy plus hypofractionated radiation therapy for borderline resectable adenocarcinoma of the head of the pancreas. BMC Cancer 17(1):505. https://doi.org/10.1186/s12885-017-3441-zCrossRefPubMedPubMedCentral

74.

Breslin TM, Hess KR, Harbison DB, Jean ME, Cleary KR, Dackiw AP, Wolff RA, Abbruzzese JL, Janjan NA, Crane CH, Vauthey JN, Lee JE, Pisters PW, Evans DB (2001) Neoadjuvant chemoradiotherapy for adenocarcinoma of the pancreas: treatment variables and survival duration. Ann Surg Oncol 8:123–132PubMedCrossRef

75.

Tachezy M, Gebauer F, Petersen C, Arnold D, Trepel M, Wegscheider K, Schafhausen P, Bockhorn M, Izbicki JR, Yekebas E (2014) 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 14:411. https://doi.org/10.1186/1471-2407-14-411CrossRefPubMedPubMedCentral

76.

O’Reilly EM, Perelshteyn A, Jarnagin WR et al (2014) A single- arm, nonrandomized phase II trial of neoadjuvant gemcitabine and oxaliplatin in patients with resectable pancreas adenocarcinoma. Ann Surg 260(1):142–148PubMedCrossRef

77.

Lutz MP, Zalcberg JR, Ducreux M, Aust D, Bruno MJ, Büchler MW, Delpero JR, Gloor B, Glynne-Jones R, Hartwig W, Huguet F, Laurent-Puig P, Lordick F, Maisonneuve P, Mayerle J, Martignoni M, Neoptolemos J, Rhim AD, Schmied BM, Seufferlein T, Werner J, van Laethem JL, Otto F (2017) 3rd St. Gallen EORTC Gastrointestinal Cancer Conference: consensus recommendations on controversial issues in the primary treatment of pancreatic cancer. Eur J Cancer 79:41–49PubMedCrossRef

78.

Kalser MH, Ellenberg SS (1985) Pancreatic cancer. Adjuvant combined radiation and chemotherapy following curative resection. Arch Surg 120(8):899–903PubMedCrossRef

79.

Klinkenbijl JH, Jeekel J, Sahmoud T et al (1999) Adjuvant radiotherapy and 5-fluorouracil after curative resection of cancer of the pancreas and periampullary region: phase III trial of the EORTC gastrointestinal tract cancer cooperative group. Ann Surg 230(6):776–782 discussion 782–4PubMedPubMedCentralCrossRef

80.

Neoptolemos JP, Stocken DD, Friess H, Bassi C, Dunn JA, Hickey H, Beger H, Fernandez-Cruz L, Dervenis C, Lacaine F, Falconi M, Pederzoli P, Pap A, Spooner D, Kerr DJ, Büchler MW, European Study Group for Pancreatic Cancer (2004) A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer. N Engl J Med 350(12):1200–1210PubMedCrossRef

81.

Neoptolemos JP, Stocken DD, Bassi C, Ghaneh P, Cunningham D, Goldstein D, Padbury R, Moore MJ, Gallinger S, Mariette C, Wente MN, Izbicki JR, Friess H, Lerch MM, Dervenis C, Olah A, Butturini G, Doi R, Lind PA, Smith D, Valle JW, Palmer DH, Buckels JA, Thompson J, McKay CJ, Rawcliffe CL, Buchler MW, European Study Group for Pancreatic Cancer (2010) Adjuvant chemotherapy with fluorouracil plus folinic acid vs gemcitabine following pancreatic cancer resection: a randomized controlled trial. JAMA 304:1073–1081PubMedCrossRef

82.

Neoptolemos JP, Moore MJ, Cox TF, Valle JW, Palmer DH, McDonald AC, Carter R, Tebbutt NC, Dervenis C, Smith D, Glimelius B, Charnley RM, Lacaine F, Scarfe AG, Middleton MR, Anthoney A, Ghaneh P, Halloran CM, Lerch MM, Oláh A, Rawcliffe CL, Verbeke CS, Campbell F, Büchler MW, European Study Group for Pancreatic Cancer (2012) Effect of adjuvant chemotherapy with fluorouracil plus folinic acid or gemcitabine vs observation on survival in patients with resected periampullary adenocarcinoma: the ESPAC-3 periampullary cancer randomized trial. JAMA 308(2):147–156PubMedCrossRef

83.

Neoptolemos JP, Palmer DH, Ghaneh P, Psarelli EE, Valle JW, Halloran CM, Faluyi O, O'Reilly DA, Cunningham D, Wadsley J, Darby S, Meyer T, Gillmore R, Anthoney A, Lind P, Glimelius B, Falk S, Izbicki JR, Middleton GW, Cummins S, Ross PJ, Wasan H, McDonald A, Crosby T, Ma YT, Patel K, Sherriff D, Soomal R, Borg D, Sothi S, Hammel P, Hackert T, Jackson R, Büchler MW, European Study Group for Pancreatic Cancer (2017) Comparison of adjuvant gemcitabine and capecitabine with gemcitabine monotherapy in patients with resected pancreatic cancer (ESPAC-4): a multicentre, open-label, randomised, phase 3 trial. Lancet 389(10073):1011–1024PubMedCrossRef

84.

Regine WF, Winter KA, Abrams RA, Safran H, Hoffman JP, Konski A, Benson AB, Macdonald JS, Kudrimoti MR, Fromm ML, Haddock MG, Schaefer P, Willett CG, Rich TA (2008) Fluorouracil vs gemcitabine chemotherapy before and after fluorouracil-based chemoradiation following resection of pancreatic adenocarcinoma: a randomized controlled trial. JAMA 299:1019–1026PubMedCrossRef

85.

Oettle H, Post S, Neuhaus P, Gellert K, Langrehr J, Ridwelski K, Schramm H, Fahlke J, Zuelke C, Burkart C, Gutberlet K, Kettner E, Schmalenberg H, Weigang-Koehler K, Bechstein WO, Niedergethmann M, Schmidt-Wolf I, Roll L, Doerken B, Riess H (2007) Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative- intent resection of pancreatic cancer: a randomized controlled trial. JAMA 297(3):267–277PubMedCrossRef

86.

Seufferlein T, Bachet JB, Van Cutsem E, Rougier P (2012) ESMO Guidelines Working Group. Pancreatic adenocarcinoma: ESMO-ESDO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 23:33–40CrossRef

87.

Conroy T, Desseigne F, Ychou M, Bouché O, Guimbaud R, Bécouarn Y, Adenis A, Raoul JL, Gourgou-Bourgade S, de la Fouchardière C, Bennouna J, Bachet JB, Khemissa-Akouz F, Péré-Vergé D, Delbaldo C, Assenat E, Chauffert B, Michel P, Montoto-Grillot C, Ducreux M, Groupe Tumeurs Digestives of Unicancer; PRODIGE Intergroup (2011) FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med 364(19):1817–1825. https://doi.org/10.1056/NEJMoa1011923CrossRefPubMed

88.

Von Hoff DD, Ervin T, Arena FP, Chiorean EG, Infante J, Moore M, Seay T, Tjulandin SA, Ma WW, Saleh MN, Harris M, Reni M, Dowden S, Laheru D, Bahary N, Ramanathan RK, Tabernero J, Hidalgo M, Goldstein D, Van Cutsem E, Wei X, Iglesias J, Renschler MF (2013) Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med 369(18):1691–1703CrossRef

89.

Moore MJ, Goldstein D, Hamm J, Figer A, Hecht JR, Gallinger S, Au HJ, Murawa P, Walde D, Wolff RA, Campos D, Lim R, Ding K, Clark G, Voskoglou-Nomikos T, Ptasynski M, Parulekar W; National Cancer Institute of Canada Clinical Trials Group (2007) Erlotinib plus gemcitabine compared with gemcitabine alone in patients with advanced pancreatic cancer: a phase III trial of the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol 25(15):1960–1966PubMedCrossRef

90.

Adamska A, Domenichini A, Falasca M (2017) Pancreatic ductal adenocarcinoma: current and evolving therapies. Int J Mol Sci 18(7):E1338. https://doi.org/10.3390/ijms18071338CrossRefPubMed

91.

House MG, Choti MA (2005) Palliative therapy for pancreatic/biliary cancer. Surg Clin North Am 85:359–371PubMedCrossRef

92.

Yoon WJ, Ryu JK, Yang KY, Paik WH, Lee JK, Woo SM, Park JK, Kim Y, Yoon YB (2009) A comparison of metal and plastic stents for the relief of jaundice in unresectable malignant biliary obstruction in Korea: an emphasis on cost-effectiveness in a country with a low ERCP cost. Gastrointest Endosc 70:284–289PubMedCrossRef

Titel: Update on Management Periampullary/Pancreatic Head Cancer
verfasst von: Mallika Tewari
Jyoti R. Swain
R. Mahendran
Publikationsdatum: 01.08.2021
Verlag: Springer India
Erschienen in: Indian Journal of Surgery / Ausgabe Sonderheft 3/2021
Print ISSN: 0972-2068
Elektronische ISSN: 0973-9793
DOI: https://doi.org/10.1007/s12262-019-02053-5

Neu im Fachgebiet Chirurgie

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 Ablationstherapie Nachrichten

Nach der Katheterablation von Vorhofflimmern kommt es bei etwa einem Drittel der Patienten zu Rezidiven, meist binnen eines Jahres. Wie sich spätere Rückfälle auf die Erfolgschancen einer erneuten Ablation auswirken, haben Schweizer Kardiologen erforscht.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 EAU 2024 Kongressbericht

Die Ureterstriktur ist eine relativ seltene Komplikation, trotzdem bedarf sie einer differenzierten Versorgung. In komplexen Fällen wird dies durch die roboterassistierte OP-Technik gewährleistet. Erste Resultate ermutigen.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare

CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare

CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske

Dr. med. Benjamin Meyknecht

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare

CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Sonderheft 3/2021

Amebic Liver Abscess Rupture into Pleural Cavity: A Rare Complication

Laparoscopic Surgery for Gallbladder Neuroendocrine Carcinoma: a Case Series and Literature Review

Chronic Pancreatitis—Update on Pathophysiology and Therapeutic Approaches

A Rare Case of Rectal Prolapse Complicated by Maggot Infestation

Corrosive Poisoning Gastric Outlet Obstruction Treated by Early Definitive Surgery

The Surgical Management of Rectal Prolapse

Update Chirurgie