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10 Cards in this Set
- Front
- Back
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What are the two most common mutations in pancreatic caner? What is the RR in a first degree family member? |
KRAS(95%), p16(90%). RR is 18X!! |
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Pancreas - 4 important genetic syndromes |
BRCA2, Familial atypica mole syndrome(p16, X20), Peutz-Jeghers(X100), HNPCC, ATM |
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Pancreas - resectibility? Is tissue diagnosis important? |
no distant mets, SMV patency, fat plane between SMA/Celiac artery and tumor. Biopsy for tissue is NOT mandatory |
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Pancreas T4 and stage III is? |
T4- unresectable SMA/Celiac stage III = T4anyN |
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LN dissection in pancreas - is extended lympadenectomy needed? |
No. 15 LN are needed however |
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Pancreas - adjuvant therapy - GITSIG, EORTC, ESPAC1, CONKO1, RTOG9704, ESPAC3 |
GITSIG - survival benefit for adjuvant CRT with 5FU (10m--20m), EORTC no survival benefit. ESPAC1 - chemorad deterimental, chemo vs no chemo survival benefit 15-->20m CONKO1 - Gemzar q3-4w for 6 cycles improves DFS and OS (20-22m) RTOG9704 - gemzar better than 5FU mOS 17--20m) ESPAC3 - gemzar same as 5FU mOS 23m |
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Pancreas - borderline tumors definition. Locally advanced definition. |
SMV invovlement, SMA involved less than 180 degrees. No celiac! Locally advanced - >180 degrees SMA. Celiac involved. |
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Pancreas - management of locally advanced |
Gemzar chemo for 2-4 cycles, those with good tolerance and no PD go on to chemord (gemzar? 5FU? not clear) |
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Metastatic pancreas - gemzar vs 5FU? |
RR 0 to 5.4%, mOS 4.4-5.6m, 1yOS 2-18% |
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Metastatic pancreas- GemOX vs Gemzar? |
RR improved to 17-26% with GemOx, PFS improved 3.7-->5.8m, no OS benefit
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