PANC-2 -Resectable Disease

Mere som dette

brighton ad sussex map

af gabby steel

Diuretic Renal Imaging

af alyssa lopez

Vet Meds

af Dresden Sutherland

Calcium Dysregulation

af Mackenzie Smith

Floating topic

Subtopic

PANC-2

Resectable Disease

High Risk Patient

Not High Risk

Neoadjuvant therapy

EUS guided biopsy

Stent

See Principles of Stent Management (PANC-B).

PANC-B

CA 19-9

Elevated CA 19-9 does not necessarily indicate cancer or advanced disease. CA 19-9 may be elevated as a result of biliary infection (cholangitis), inflammation, or obstruction, benign or malignant. In addition, CA 19-9 will be undetectable in Lewis antigen-negative individuals.

Chest/Pelvic CT

Imaging with contrast unless contraindicated.

Surgery

Surgery (laparotomy or minimally invasive surgery)

See Principles of Surgical Technique (PANC-D) and Pathologic Analysis: Specimen Orientation, Histologic Sections, and Reporting (PANC-E).

Successful Resection?

See Principles of Surgical Technique (PANC-D) and Pathologic Analysis: Specimen Orientation, Histologic Sections, and Reporting (PANC-E).

PANC-4

PANC-5

Pancreatic CT/MRI

Proceed to surgery (without neoadjuvant therapy)

High Risk: Consider staging laparoscopy

High-risk features include imaging findings, very highly elevated CA 19-9, large primary tumors, large regional lymph nodes, excessive weight loss, extreme pain.

Neoadjuvent therapy

There is limited evidence to recommend specific neoadjuvant regimens off-study, and practices vary with regard to the use of chemotherapy and chemoradiation. See Principles of Systemic Therapy (PANC-F) for acceptable neoadjuvant options.

Subsequent chemoradiation is sometimes included; see Principles of Radiation Therapy (PANC-G).

PANC-G

PANC-F