Flashcards in B11. Epidemiology, etiology, histology, staging, symptoms and diagnosis of pancreatic cancer Deck (14):
Pancreatic cancer epidemiology
4th most common causes of cancer
Most common pancreatic cancer?
Exocrine adenocarcinomas and neuroendocrine carcinoma. Rarely: endocrine tumors (insulinomas, glucagonoma)
Risk factors for pancreatic cancer
-smoking 2-5x,increased risk, most clearly established risk factor
-high fat/low fiber, diets, heavy alcohol abuse
-DM, chronic pancreatitis
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)
Body or tail or pancreas (30%)
-tends to present later and usually inoperable
-weight loss, vague midepigastric pain
-sudden onset DM
T of TNM for pancreatic cancer
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
N1 for pancreatic cancer means
Regional LN metastases
Stage 0 pancreatic cancer? Treatment?
Tis, N0, M0
Treatment is surgical resection and chemotherapy
Stage 1a for pancreatic cancer? 5 year survival rate? Treatment?
T1, N0, M0.
Surgical resection +/- chemotherapy
T2, N0, M0.
Stage IIA pancreatic cancer
T3, N0, M0
Stage IIB pancreatic cancer
T1-3, N1, M0
Stage III pancreatic cancer? 5 year survival? Treatment
T4, any N, M0
3% 5 year survival
Borderline resectable, trial of chemotherapy and radiation
Stage IV pancreatic cancer
Any T, any N, M1
1% 5 year survival rate
Non-resectable palliative treatment