B11. Epidemiology, etiology, histology, staging, symptoms and diagnosis of pancreatic cancer Flashcards Preview

Oncology > B11. Epidemiology, etiology, histology, staging, symptoms and diagnosis of pancreatic cancer > Flashcards

Flashcards in B11. Epidemiology, etiology, histology, staging, symptoms and diagnosis of pancreatic cancer Deck (14):
1

Pancreatic cancer epidemiology

4th most common causes of cancer

2

Most common pancreatic cancer?

Exocrine adenocarcinomas and neuroendocrine carcinoma. Rarely: endocrine tumors (insulinomas, glucagonoma)

3

Risk factors for pancreatic cancer

Risk factors: 
-increased age 
-smoking 2­-5x,increased risk, most clearly established risk factor   
­-high fat/low fiber, diets, heavy alcohol abuse 
­-obesity 
­-DM, chronic pancreatitis 
­-chemicals 

4

Clinical features of pancreatic cancer? Where does it effect and symptoms?

Head of pancreas  (70%) 
­-weight loss, obstructive jaundice, steatorrhea, vague constant mid­epigastric pain 
(often worse at night, may radiate to back) 
-painless jaundice, Courvoisier’s sign (nontender but palpable distended gallbladder) 
-thrombophlebitis.  
Body or tail or pancreas (30%)
-tends to present later and usually inoperable 
-weight loss, vague  mid­epigastric pain 
-<10% jaundiced 
-sudden onset DM 

5

T of TNM for pancreatic cancer

Tis-in situ
T1= <2 cm, confined in pancreas
T2= >2 cm, confined in pancreas
T3= Tumor invades past pancreas, without invading blood vessels
T4= Tumor infiltrates large blood vessels, unresectable

6

N1 for pancreatic cancer means

Regional LN metastases

7

Stage 0 pancreatic cancer? Treatment?

Tis, N0, M0
Treatment is surgical resection and chemotherapy

8

Stage 1a for pancreatic cancer? 5 year survival rate? Treatment?

T1, N0, M0.
14%.
Surgical resection +/- chemotherapy

9

Stage IB?

T2, N0, M0.

10

Stage IIA pancreatic cancer

T3, N0, M0

11

Stage IIB pancreatic cancer

T1-3, N1, M0

12

Stage III pancreatic cancer? 5 year survival? Treatment

T4, any N, M0
3% 5 year survival
Borderline resectable, trial of chemotherapy and radiation

13

Stage IV pancreatic cancer

Any T, any N, M1
1% 5 year survival rate
Non-resectable palliative treatment

14

Diagnostics for pancreatic cancer

-Can have elevated ALP and high bilirubin
-CA 19-9
-US, CT +/- ERCP, MRI, EUS