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Transcript of © 2008 Luzerner Kantonsspital Advanced Pancreatic Cancer Swiss Tumorboard, Berne 26.3.2009 ...
![Page 1: © 2008 Luzerner Kantonsspital Advanced Pancreatic Cancer Swiss Tumorboard, Berne 26.3.2009 04.10.2015 PD Dr. J. Metzger Chefarzt.](https://reader030.fdocuments.net/reader030/viewer/2022032605/56649e855503460f94b86e71/html5/thumbnails/1.jpg)
© 2008 Luzerner Kantonsspital
Advanced Pancreatic Cancer
Swiss Tumorboard, Berne
26.3.2009
www.magendarm-zentrum.ch19.04.23
PD Dr. J. Metzger
Chefarzt Viszeralchirurgie
![Page 2: © 2008 Luzerner Kantonsspital Advanced Pancreatic Cancer Swiss Tumorboard, Berne 26.3.2009 04.10.2015 PD Dr. J. Metzger Chefarzt.](https://reader030.fdocuments.net/reader030/viewer/2022032605/56649e855503460f94b86e71/html5/thumbnails/2.jpg)
© 2008 Luzerner Kantonsspital
Patient: male, 55 y
epigastric pain, itching (jaundice), loss of weight (5kg)
D.m.; BMI 30.4 kg/m2 (5 kg ↓↓)
diagnostic: CT (abdomen)
MRI
ERCP papillotomy & stent 23.12.2008
www.magendarm-zentrum.ch
![Page 3: © 2008 Luzerner Kantonsspital Advanced Pancreatic Cancer Swiss Tumorboard, Berne 26.3.2009 04.10.2015 PD Dr. J. Metzger Chefarzt.](https://reader030.fdocuments.net/reader030/viewer/2022032605/56649e855503460f94b86e71/html5/thumbnails/3.jpg)
© 2008 Luzerner Kantonsspital
CT-scan
![Page 4: © 2008 Luzerner Kantonsspital Advanced Pancreatic Cancer Swiss Tumorboard, Berne 26.3.2009 04.10.2015 PD Dr. J. Metzger Chefarzt.](https://reader030.fdocuments.net/reader030/viewer/2022032605/56649e855503460f94b86e71/html5/thumbnails/4.jpg)
© 2008 Luzerner Kantonsspital
MRI
![Page 5: © 2008 Luzerner Kantonsspital Advanced Pancreatic Cancer Swiss Tumorboard, Berne 26.3.2009 04.10.2015 PD Dr. J. Metzger Chefarzt.](https://reader030.fdocuments.net/reader030/viewer/2022032605/56649e855503460f94b86e71/html5/thumbnails/5.jpg)
© 2008 Luzerner Kantonsspital
ERCP
![Page 6: © 2008 Luzerner Kantonsspital Advanced Pancreatic Cancer Swiss Tumorboard, Berne 26.3.2009 04.10.2015 PD Dr. J. Metzger Chefarzt.](https://reader030.fdocuments.net/reader030/viewer/2022032605/56649e855503460f94b86e71/html5/thumbnails/6.jpg)
© 2008 Luzerner Kantonsspital
Questions to the panel
any further diagnostic (biopsy?)
would you consider neoadjuvant treatment?
![Page 7: © 2008 Luzerner Kantonsspital Advanced Pancreatic Cancer Swiss Tumorboard, Berne 26.3.2009 04.10.2015 PD Dr. J. Metzger Chefarzt.](https://reader030.fdocuments.net/reader030/viewer/2022032605/56649e855503460f94b86e71/html5/thumbnails/7.jpg)
© 2008 Luzerner Kantonsspital
Surgery
intraoperativefindings:
![Page 8: © 2008 Luzerner Kantonsspital Advanced Pancreatic Cancer Swiss Tumorboard, Berne 26.3.2009 04.10.2015 PD Dr. J. Metzger Chefarzt.](https://reader030.fdocuments.net/reader030/viewer/2022032605/56649e855503460f94b86e71/html5/thumbnails/8.jpg)
© 2008 Luzerner Kantonsspital
pancreas remnant
A. hepatica com.
portal veininfiltration
![Page 9: © 2008 Luzerner Kantonsspital Advanced Pancreatic Cancer Swiss Tumorboard, Berne 26.3.2009 04.10.2015 PD Dr. J. Metzger Chefarzt.](https://reader030.fdocuments.net/reader030/viewer/2022032605/56649e855503460f94b86e71/html5/thumbnails/9.jpg)
© 2008 Luzerner Kantonsspital
Questions to the panel
resection of the portal vein
extension of lymphadenectomy
![Page 10: © 2008 Luzerner Kantonsspital Advanced Pancreatic Cancer Swiss Tumorboard, Berne 26.3.2009 04.10.2015 PD Dr. J. Metzger Chefarzt.](https://reader030.fdocuments.net/reader030/viewer/2022032605/56649e855503460f94b86e71/html5/thumbnails/10.jpg)
© 2008 Luzerner Kantonsspital
Final Histology
adenocarcinoma; G3
primary Tumor: 2.5x3.5 cm
pN1: (1|16)
resection margins:pancreas: free
duodenum free
bile duct free
retroperitoneal ? closed to the margin
pT3pN1 M0, G3
![Page 11: © 2008 Luzerner Kantonsspital Advanced Pancreatic Cancer Swiss Tumorboard, Berne 26.3.2009 04.10.2015 PD Dr. J. Metzger Chefarzt.](https://reader030.fdocuments.net/reader030/viewer/2022032605/56649e855503460f94b86e71/html5/thumbnails/11.jpg)
© 2008 Luzerner Kantonsspital
![Page 12: © 2008 Luzerner Kantonsspital Advanced Pancreatic Cancer Swiss Tumorboard, Berne 26.3.2009 04.10.2015 PD Dr. J. Metzger Chefarzt.](https://reader030.fdocuments.net/reader030/viewer/2022032605/56649e855503460f94b86e71/html5/thumbnails/12.jpg)
© 2008 Luzerner Kantonsspital
Questions to the panel
adjuvant treatment?
Cx alone?
Cx and RT?