Pancreatic Cancer Mortality Causes
Causative Factors of Death
- The American College of Surgeons and other medical organizations acknowledge that metastatic disease is a major cause of death in pancreatic cancer patients, with liver metastases being the most frequent cause, present in the majority of patients with malignant pancreatic neuroendocrine tumors 2, 3
- Systemic dissemination occurs rapidly due to vascular invasion and lymph node metastases, which are present in 40-75% of primary tumors less than 2 cm in diameter, according to the European Society for Medical Oncology 4
- Infiltration of the retroperitoneal space with persistent back pain indicates incurability, as stated by the European Society for Medical Oncology 4
- Biliary obstruction due to tumors of the pancreatic head or liver/hilar metastases is a common complication, as reported by the European Society for Medical Oncology 4
- Duodenal obstruction requires stenting or surgical bypass, as recommended by the American Gastroenterological Association 5
Prognostic Factors for Mortality
- Positive resection margins (R1) dramatically reduce survival, according to the European Society for Medical Oncology 7, 5
- Lymph node metastases (N+) result in rare long-term survival, as stated by the American Joint Committee on Cancer 8, 1
- Even after complete resection, 5-year survival is only 10-20%, increasing to 25% with adjuvant chemotherapy, as reported by the American Society of Clinical Oncology 1, 5
- Recurrence of the disease occurs in 21-42% of patients with resected pancreatic neuroendocrine tumors, and can occur after many years, according to the National Comprehensive Cancer Network 2, 6
Special Considerations for Specific Tumor Types
- Most glucagonomas are malignant, calcified, and located in the tail of the pancreas, with regional lymph node involvement, as stated by the National Comprehensive Cancer Network 2, 6
- Patients with metastatic disease will experience recurrence even after resection or ablation, according to the National Comprehensive Cancer Network 2
- Ten-year survival can reach 50.4% after resection of liver metastases in selected cases, as reported by the National Comprehensive Cancer Network 2