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.
Stage
I
II
III
IV
Percent at diagnosis
60%
45%
30%
15%
0%
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
Pancreatic Resection
Distal Pancreatectomy (no Appleby)
Whipple operation (Pancreaticoduodenectomy)
Standard Whipple