文档介绍：ancer Epidemiology2014-46,420newcasesinUSA2014-39,monGIcancerkiller(colon#1)ancer EpidemiologyNewCancerDeaths,UnitedStates, EpidemiologyIncidenceincreasing1%ancer Epidemiology85%ofnewcasesareadvancedLocallyadvanced:bloodvessels(StageIII)Distantspreadtoliver,lungs(StageIV)LatePresentation-PoorSurvivalHowlanderetal,,CancerFacts&%45%30%15%0%LatePresentation-PoorSurvivalHowlanderetal,,CancerFacts&(mos)StageIIIIIIIV0Even“early”stagediseaseisadvancedNoSurgeryIf..Majorbloodvesselsinvolved(StageIII)Distantmetastases(StageIV)SomeStageIIImaybeexceptionsPancreaticResectionDistalPancreatectomy(noAppleby)Whippleoperation(Pancreaticoduodenectomy)StandardWhippleStandardWhippleRoux-en-Yrarelydone