文档介绍：Howard A. Reber, MD
Professor of Surgery
UCLA School of Medicine
Pancreatic Cancer Surgical Approach in the USA - 2014
Agi Hirshberg Center for Pancreatic Diseases
at UCLA
Pancreatic Cancer Epidemiology
2014 - 46,420 new cases in USA
2014 - 39,590 deaths
4th mon cancer killer
2nd mon GI cancer killer (colon #1)
Pancreatic Cancer Epidemiology
New Cancer Deaths , United States, 2014.
Pancreatic Cancer Epidemiology
Incidence increasing
1% yearly
Pancreatic Cancer Epidemiology
85% of new cases are advanced
Locally advanced: blood vessels (Stage III)
Distant spread to liver, lungs (Stage IV)
Late Presentation - Poor Survival
Howlander et al, SEER Cancer Statistics Review 2012.
American Cancer Society, Cancer Facts & Figures 2013.
24
18
12
6
0
Median
Survival
(mos)
Stage
I
II
III
IV
0
Even “early”
stage disease
is advanced
No Surgery
If..
Major blood vessels involved (Stage III)
Distant metastases (Stage IV)
Some Stage III may be exceptions
Pancreatic Resection
Distal Pancreatectomy (no Appleby)
Whipple operation (Pancreaticoduodenectomy)
Standard Whipple