Karcinom gušterače

master's thesis

• Title (english): Pancreatic cancer
• Author: Marko Krnić
• Mentor: Marko Sever (mentor)
• Committee member: Žarko Rašić (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Marko Sever (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Oncology

Abstract

Karcinom gušterače najčešća je zloćudna novotvorina egzokrine gušterače. Procjenjuje se da je kod nas karcinom gušterače treći maligni tumor probavnoga sustava po učestalosti te četvrti najčešći uzrok smrti od zloćudnih novotvorina. Incidencija karcinoma gušterače u zapadnim zemljama prosječno iznosi 10 na 100 000 ljudi godišnje. Čak 60% do 70% karcinoma gušterače smješteni su u području glave gušterače, a ostalih 20 do 25% smješteni su u području trupa ili repa gušterače. Među najčešće simptome ubrajaju se abdominalna bol, gubitak tjelesne mase te žutica. Dijagnoza karcinoma gušterače se postavlja na temelju kliničke slike te ukupnih rezultata laboratorijskih, radioloških, endoskopskih pretraga kao i patohistološke analize bioptata. Procjena proširenosti karcinoma gušterače uvjet je za ispravan odabir terapijskoga pristupa. Kirurško liječenje jedina je potencijalno kurabilna metoda liječenja karcinoma gušterače. Karcinomi glave gušterače kirurški se liječe duodenopankreatektomijom (Whippleov zahvat). Danas postoji nekoliko modifikacija toga zahvata među kojima je i laparoskopska duodenopankreatektomija. Karcinomi trupa i repa gušterače liječe se distalnom pankreatektomijom sa splenektomijom. Totalna pankreatektomija danas se rijetko izvodi, u slučajevima proširenih karcinoma glave i trupa gušterače odnosno primarnog tumora u području vrata gušterače. Perioperativni mortalitet izrazito je smanjen od prošlog stoljeća i u većih centara iznosi oko 2%. Perioperativni morbiditet se nije smanjio te varira između 20 % i 30% ovisno o centru i vrsti operativnoga zahvata. Kemoterapija predstavlja važan terapijski modalitet za pacijente oboljele od karcinoma gušterače, a razlikujemo neoadjuvantnu, adjuvantnu odnosno inicijalnu (palijativnu) kemoterapiju. Radioterapija je važan palijativni terapijski modalitet. Postoje kemoradioterapijski protokoli, koji u Europi, kao metoda potencijalno kurabilnoga liječenja, ostaju u okviru kliničkih istraživanja.

Abstract (english)

Pancreatic cancer is the most common malignant neoplasm of exocrine pancreas. It is estimated that in our country, pancreatic cancer is the third malignant tumor of the digestive system, and the fourth cause of death from malignant neoplasms. In western countries pancreatic cancer incidence rate averages 10 per 100,000 people annually. Almost 60% to 70% of pancreatic tumors are located in the head of pancreas, while the other 20% to 25% are located in the area of the body or tail of pancreas. Most common symptoms include abdominal pain, loss of weight and jaundice. Pancreatic cancer diagnosis is based on the clinical picture and the overall results of laboratory, radiological, endoscopic examinations as well as pathohistological biopsy analysis. Clinicopathologic staging is a prerequisite for the correct choice of therapeutic approach. Surgical treatment is the only curative method of treatment for pancreatic cancer. Pancreatic head cancer is surgically treated by duodenopancreatectomy (Whipple's procedure). Today, there are several modifications of this procedure, including laparoscopic duodenopancreatectomy. Pancreatic body or tail cancer is treated with distal pancreatectomy and splenectomy. Total pancreatectomy is rarely performed today, most often in cases of enlarged tumors arising from the head or the body of pancreas whereas primary tumors of pancreatic neck. Perioperative mortality has been significantly reduced since the last century and in larger centers it is around 2%. Perioperative morbidity has not decreased and varies between 20% and 30% depending on the center and type of operative procedure. Chemotherapy is an important therapeutic modality for patients suffering from pancreatic cancer, and we differentiate neoadjuvant, adjuvant or initial (palliative) chemotherapy. Radiotherapy is an important palliative therapeutic modality. There are some chemoradiotherapeuthic protocols, which in Europe as a method of potentially curative treatment remain within the scope of clinical research.

• Keywords: karcinom gušterače; kirurško liječenje; duodenopankreatektomija; Whippleov zahvat
• Keywords (english): pancreatic cancer; surgical treatment; duodenopankreatectomy; Whipple's procedure
• Language: croatian
• URN:NBN: urn:nbn:hr:105:882617
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-10-22 07:20:52