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© 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
© 2008 Luzerner Kantonsspital
ERCP
© 2008 Luzerner Kantonsspital
Questions to the panel
any further diagnostic (biopsy?)
would you consider neoadjuvant treatment?
© 2008 Luzerner Kantonsspital
Surgery
intraoperativefindings:
© 2008 Luzerner Kantonsspital
pancreas remnant
A. hepatica com.
portal veininfiltration
© 2008 Luzerner Kantonsspital
Questions to the panel
resection of the portal vein
extension of lymphadenectomy
© 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
© 2008 Luzerner Kantonsspital
© 2008 Luzerner Kantonsspital
Questions to the panel
adjuvant treatment?
Cx alone?
Cx and RT?