Резюме
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- jaundice
- nonspecific upper abdominal pain or discomfort
- weight loss and anorexia
- back pain
Другие диагностические факторы
- age 65-74 years
- steatorrhea
- thirst, polyuria, nocturia, and weight loss
- nausea, vomiting, and early satiety
- unexplained acute pancreatitis
- hepatomegaly
- epigastric abdominal mass
- positive Courvoisier sign
- petechiae, purpura, bruising
- Trousseau sign (migratory thrombophlebitis)
Факторы риска
- smoking
- family history of pancreatic cancer
- other hereditary cancer syndromes
- chronic sporadic pancreatitis
- diabetes mellitus
- obesity
- dietary factors
Диагностические исследования
Исследования, которые показаны в первую очередь
- pancreatic protocol CT
- abdominal ultrasound
- LFTs
Исследования, проведение которых нужно рассмотреть
- prothrombin time (PT)
- CBC
- cancer antigen (CA)19-9 biomarker
- positron emission tomography
- endoscopic retrograde cholangiopancreatography (ERCP)
- MRI
- magnetic resonance cholangiopancreatography
- endoscopic ultrasound
- staging laparoscopy (with laparoscopic ultrasound)
- biopsy
Неотложные исследования
- genomic testing
Алгоритм лечения
resectable (stages 1 and 2)
locally advanced unresectable (stage 3)
metastatic (stage 4)
Составители
Авторы
Hemant M. Kocher, MBBS, MS, MD, FRCS
Professor of Liver and Pancreas Surgery
Barts Cancer Institute
Barts and The London School of Medicine and Dentistry
London
UK
Раскрытие информации
HMK is an author of a number of references cited in this topic. HMK has received research grants from Bristol-Myers-Squibb (formerly Celgene) for investigator-initiated clinical trials. HMK has unrestricted educational grants from Meril, Mylan, Medtronics, and Ethicon.
Выражение благодарностей
Dr Hemant M. Kocher wishes to gratefully acknowledge Dr Fieke E.M. Froeling, a previous contributor to this topic.
Раскрытие информации
FEMF is an author of a reference cited in this topic.
Рецензенты
Ross Carter, FRCS
Consultant Pancreatic Surgeon
West of Scotland Pancreatic Unit
Glasgow Royal Infirmary
Glasgow
UK
Раскрытие информации
Not disclosed.
Nikhil I. Khushalani, MD
Assistant Professor of Oncology
Roswell Park Cancer Institute
Buffalo
NY
Раскрытие информации
NIK has received funding for the conduction of clinical trials and associated translational studies from Merck, Pfizer, and Astra-Zeneca. NIK has a grant from the National Comprehensive Cancer Network (from research support by Roche).
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: pancreatic adenocarcinoma [internet publication].Полный текст
Conroy T, Pfeiffer P, Vilgrain V, et al. Pancreatic cancer: ESMO clinical practice guideline for diagnosis, treatment and follow-up. Ann Oncol. 2023 Nov;34(11):987-1002.Полный текст Аннотация
Sohal DPS, Kennedy EB, Cinar P, et al. Metastatic pancreatic cancer: ASCO guideline update. J Clin Oncol. 2020 Aug 5:JCO2001364.Полный текст Аннотация
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Chronic pancreatitis
- Bile duct stones
- Ampullary carcinoma
Больше ОтличияРекомендации
- NCCN clinical practice guidelines in oncology: pancreatic adenocarcinoma
- ESMO clinical practice guideline express update on the management of metastatic pancreatic cancer
Больше РекомендацииЛифлеты для пациента
Pancreatic cancer
Pancreatic cancer: questions to ask your doctor
Больше Лифлеты для пациентаВойдите в учетную запись или оформите подписку, чтобы получить полноценный доступ к BMJ Best Practice
Использование этого контента попадает под действие нашего заявления об отказе от ответственности