© 2008 Luzerner Kantonsspital 

Advanced Pancreatic Cancer

Swiss Tumorboard, Berne

26.3.2009

www.magendarm-zentrum.ch19.04.23

PD Dr. J. Metzger

Chefarzt Viszeralchirurgie

© 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

© 2008 Luzerner Kantonsspital 

CT-scan

© 2008 Luzerner Kantonsspital 

MRI

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ERCP

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Questions to the panel

any further diagnostic (biopsy?)

would you consider neoadjuvant treatment?

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Surgery

intraoperativefindings:

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pancreas remnant

A. hepatica com.

portal veininfiltration

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Questions to the panel

resection of the portal vein

extension of lymphadenectomy

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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

© 2008 Luzerner Kantonsspital 

© 2008 Luzerner Kantonsspital 

Questions to the panel

adjuvant treatment?

Cx alone?

Cx and RT?