Maligne Tumoren des Pankreas und der periampullären Region

Gall, F. P.; Zirngibl, Hubert

doi:10.1007/978-3-642-69600-8_23

Cited by 10 publications

(11 citation statements)

References 102 publications

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“…Surprisingly, the median survival of 12.0 months in our nonresectable patients without distant metastases (UICC III) was similar to the median survival time to be expected after resection. The median survival time for resected patients has been 12.8 months according to reviews of the literature [27] and 11.3 months in 168 patients resected at our institution before multimodal concepts for pancreatic cancer treatment involving che motherapeutic protocols were initiated [2], The median survival of our regionally treated UICC IV patients, who all had liver metastases, was slightly better than the 1-2 months to be anticipated [28]. The suggested benefit of regional chemotherapy in nonresectable pancreatic can cer has to be proven by comparing the survival to either matched historical controls or to systemic standard che motherapy or radiochemotherapy in randomized studies.…”

Section: Discussionmentioning

confidence: 99%

Regional Treatment of Advanced Nonresectable and of Resected Pancreatic Cancer via Celiac Axis Infusion

et al. 1994

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Thirty-two patients with advanced nonresectable pancreatic cancer of UICC stages III (17 patients) and IV (15 patients; palliative group) received regional chemotherapy with mitoxantrone, 5-FU + folinic acid, and cisplatin via celiac axis infusion with the Seldinger technique. Twenty patients received this treatment after resection of their primary tumors (adjuvant group). Overall 202 cycles [4(1-11)/patient] were applied. Toxicities in all cycles were as follows: gastrointestinal ulcers 6%, gastritis 5%, severe stomatitis 0.5%, nausea/vomiting WHO I+ 11 44%, leukopenia WHO I+ II 11% and WHO III 0.5%. A false aneurysm and a hematoma developed in 1 patient each. The median survival times were 7.5 months in the palliative group (UICC III 12 months, UICC IV 4 months) and 15.1 months in the adjuvant group. Pain decreased significantly in the palliative group.

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Section: Discussionmentioning

confidence: 99%

Regional Treatment of Advanced Nonresectable and of Resected Pancreatic Cancer via Celiac Axis Infusion

et al. 1994

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“…Definitionsgemfil3 geh6ren zu den periampullfiren Karzinomen Karzinome der Ampulle, des terminalen Ductus choledochus, des Endteils des Ductus Wirsungianus und der Duodenalschleimhaut in unmittelbarer Nachbarschaft der Papilla Vateri [5,9,22]. Allein die getrennte Berficksichtigung dieser unterschiedlichen Lokalisation periampullS, rer Karzinome hat aber Einflul3 auf die Prognose.…”

Section: Patienten Und Methodeunclassified

“…Allein die getrennte Berficksichtigung dieser unterschiedlichen Lokalisation periampullS, rer Karzinome hat aber Einflul3 auf die Prognose. So lagen in 2 Untersuchungsserien die Ffint]ahresiiberlebensraten von Karzinomen, die vonder papillennahen Duodenalschleimhaut ausgingen, mit 32% wesentlich gfinstiger als die vom terminalen Ductus choledochus ausgehenden Karzinome mit Ffinfjahresfiberlebensraten von nur 19% [5,8,22]. AuBerdem finden sich unter den polypoidwachsenden kleinen periampull/iren Karzinomen, wie sie auch in unserem Krankengut vorlagen, hfiufiger hochdifferenzierte Adenokarzinome mit gfinstigem biologischem Verhalten [5,9,14].…”

Section: Patienten Und Methodeunclassified

Eingeschr�nkte chirurgische Radikalit�t beim okkulten Karzinom der Papilla Vateri

Koch

Hildebrandt

Schüder

et al. 1991

Langenbecks Arch Chir

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Nine histologically proven benign adenomas of the papilla of Vater were consecutively treated by transduodenal full thickness excision and simultaneous staging of regional lymph nodes without severe postoperative complications. 4 patients had a small well differentiated (pT1 GIpN0) carcinoma, although there was neither macroscopically nor by frozen sections any suspicion of a malignant tumour. A more radical pancreatoduodenectomy was not carried out and the 4 patients are without tumour recurrence or metastases 1-8 years postoperatively.

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“…In other published studies the median survival time after resection without adjuvant treatment ranges between 12.8 and 15.8 months and the 5-year survival rates range from 5.1 to 6.7% in all stages [17], In two randomized trials comparing resection only to either systemic adjuvant treatment [ 18] or radiochemo therapy [4], the median survival times of the resection only groups were 11 and 10.9 months, respectively. In our department, we have followed a rather aggressive resec tion policy with a resection rate of 38% at a perioperative mortality of 4%.…”

Section: Discussionmentioning

confidence: 99%

Regional Celiac Artery Infusion as Adjuvant Treatment after Pancreatic Cancer Resection

et al. 1997

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Background/Aims: The dismal course of pancreatic adenocarcinoma patients after resection is determined by the biology of the disease preventing R-0 resections. In the spontaneous course after resection, patients frequently develop either local recurrences, liver metastases and/or peritoneal metastases. Postoperative radiochemotherapy may extend survival and reduce local recurrences without influence on hepatic progression. We performed adjuvant celiac artery infusion in pancreatic cancer, to find out whether this treatment prolongs survival and changes the biology of the disease after resection, especially by reducing liver metastasis. Methods: 20 patients received cyclic celiac artery infusions (CAI) after resection of their pancreatic cancer (18 ductal, 2 cystadenocarcinoma). The treatment consisted of 6 cycles intraarterial infusion using Seldinger’s technique with mitoxantrone (Novantron®, Wyeth-Le-derle, Germany) 10mg/m² d1, 5-fluorouracil + folinic acid (Fluroblastin®, Farmitalia, Germany + Leucovorin®, Wyeth-Lederle) 600 mg/m² + 170 mg/ m² d2-4, and cis-platinum (Cisplatin®, Bristol, München, Germany) 60 mg/ m2 d5. The patients were monitored for toxicity, development of disease progression and survival. Results: The median survival time was 21 months, and only 15% of the patients developed liver metastases. The median survival time of the CAI-treated patient group compared favorably to the median survival of 9.3 months in a matched historical control group. Conclusion: Adjuvant celiac artery infusion seemed to prolong median survival and the occurrence of liver metastases appeared to be delayed or reduced.

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Maligne Tumoren des Pankreas und der periampullären Region

Cited by 10 publications

References 102 publications

Regional Treatment of Advanced Nonresectable and of Resected Pancreatic Cancer via Celiac Axis Infusion

Regional Treatment of Advanced Nonresectable and of Resected Pancreatic Cancer via Celiac Axis Infusion

Eingeschr�nkte chirurgische Radikalit�t beim okkulten Karzinom der Papilla Vateri

Regional Celiac Artery Infusion as Adjuvant Treatment after Pancreatic Cancer Resection

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