Anonymous User
Login / Registration

a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2018; 72(5): 385–390. doi:10.14735/amgh2018385.

Karcinom pankreatu z pohledu pacienta

Miroslav Ryska1

+ Affiliation


Ductal adenocarcinoma of the pancreas is currently a major health problem in developed countries. The Czech population has the highest incidence of ductal adenocarcinoma in Europe according to recent reports, and the incidence is expected to double by 2030. Radical resection, in combination with adjuvant chemotherapy, is the only treatment choice that can result in a cure. Significant disease progression after the first symptoms become noticeable results in poor treatment success. It is therefore very important to follow rational diagnostic and therapeutic procedures and to form as soon as possible a multidisciplinary team around the patient to group the patients into primary resectable, borderline resectable, and non-resectable (locally advanced or metastatic) groups, and to initiate adequate therapy. The purpose of the present communication is to introduce the reader to likely patient attitudes at different disease stages and in different treatment  groups.


diagnosis, pancreatic cancer, patient’s view, therapy

To read this article in full, please register for free on this website.

Benefits for subscribers

Benefits for logged users


1. Loveček M, Skalický P, Ryska M et al. Aktuální stav chirurgické léčby karcinomu pankreatu v České republice. Rozhl Chir 2016; 95 (4): 151–162.
2. Yamaguchi K, Okusaka T, Shimizu K et al. Clinical practice guidelines for pancreatic cancer 2016 from the Japan Pancreas Society: a synopsis. Pancreas 2017; 46: 595–604. doi: 10.1097/MPA.0000000000000816.
3. Pancreatic Adenocarcinoma, Version 2.2017, NCCN clinical practice guidelines in onkology. J Natl Compr Canc Netw 2017; 15 (8): 1028–1061. doi: 10.6004/jnccn.2017.0131.
4. van Rijssen LB, van der Geest LG, Bollen TL et al. National compliance to an evidence-based multidisciplinary guideline on pancreatic and periampullary carcinoma. Pancreatology 2016; 16: 133–137. doi: 10.1016/j.pan.2015.10.002.
5. Seufferlein T, Porzner M, Heinemann V et al. Ductal pancreatic adenocarcinoma. Dtsch Arztebl Int 2014; 111 (22): 396–402. doi: 10.3238/arztebl. 2014.0396.
6. Klinický standard pro diagnostiku a léčbu pa-cientů se zhoubným onemocněním pankreatu. Národní sada klinických standardů. Národní referenční centrum 2011. [online]. Dostupné z: https: //
7. Glanemann M, Shi B, Liang F et al. Surgical strategies for treatment of malignit pancreatic tumors: extended, standard or local surgery? World J Surg Oncol 2008; 6: 123. doi: 10.1186/1477-7819-6-123.
8. Ryska M, Rudiš J. Total pancreatectomy for pancreatic malignancy – from history to the present day. Rozhl Chir 2016; 95 (10): 345–349.
9. Bockhorn M, Uzunoglu FG, Adham M et al. Borderline resectable pancreatic cancer: a consensus statement by the International Study Group of Pancreatic Surgery (ISGPS). Surgery 2014; 155 (6): 977–988. doi: 10.1016/j.surg.2014.02.001.
10. Hackert T, Strobel O, Michalski CW et al. The TRIANGLE operation – radical surgery after neoadjuvant treatment for advanced pancreatic cancer: a single arm observational study. HPB (Oxford) 2017; 19 (11): 1001–1007. doi: 10.1016/j.hpb.2017.07.007.
11. de Geus SW, Evans DB, Bliss LA et al. Neoadjuvant therapy versus upfront surgical strategies in resectable pancreatic cancer: a Markov decision analysis. Eur J Surg Oncol 2016; 42 (10): 1552–1560. doi: 10.1016/j.ejso.2016.07. 016.
12. Maisonneuve P, Lowenfels AB. Risk factors for pancreatic cancer: a summary review of meta-analytical studies. Int J Epidemiol 2015; 44 (1): 186–198. doi: 10.1093/ije/dyu240.
13. Frič P, Škrha J, Šedo A et al. Early pancreatic carcinogenesis – risk factors, early symptoms, and the impact of antidiabetic drugs. Eur J Gastroenterol Hepatol 2016; 7: e19–e25. doi: 10.1097/MEG.0000000000000646.
14. Merdrignac A, Sulpice L, Rayar M et al. Pancreatic head cancer in patients with chronic pancreatitis. Hepatobiliary Pancreat Dis Int 2014; 13 (2): 192–197.
15. Yachida S, Jones S, Bozic I et al. Distant metastasis occurs late during the genetic evolution of pancreatic cancer. Nature 2010; 467 (7319): 1114–1117. doi: 10.1038/nature09515.
16. Yeo TP. Demographics, epidemiology, and inheritance of pancreatic ductal adenocarcinoma. Semin Oncol 2015; 42 (1): 8–18. doi: 10.1053/j.seminoncol.2014.12.002.
17. Kenner BJ, Chari ST, Maintra A et al. Early detection of pancreatic cancer – a defined future using lessons from other cancers: a white paper. Pancreas 2016; 45 (8): 1073–1079. doi: 10.1097/MPA.0000000000000701.
18. Yu J, Blackford AL, Dal Molin M et al. Time to progression of pancreatic ductal adenocarcinoma from low-to-high tumour stages. Gut 2015; 64 (11): 1783–1789. doi: 10.1136/ gutjnl-2014-308653.
19. De la Cruz MS, Young AP, Ruffin MT et al.  Diagnosis and management of pancreatic cancer Am Fam Physician 2014; 89 (8): 626–632.
20. Ducreux M, Cuhna AS, Caramelia C et al. Cancer of the pancreas: ESMO clinical practice  guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015; 26 (Suppl 5): v56–v68. doi: 10.1093/annonc/mdv295.
21. Pietryga JA, Morgan DE. Imaging preoperatively for pancreatic adenocarcinoma. J Gastrointest Oncol 2015; 6 (4): 343–357. doi: 10.3978/ j.issn.2078-6891.2015.024.
22. Pisters PW, Hudec WA, Hess KR et al. Effect of praeoperative biliary decompression on pancreaticoduodenectomy – associated morbidity in 300 consecutive patients. Ann Surg 2001; 234: 47–55.
23. Cooper M, Newman NA, Ibrahim AM et al. Unnecessary tests and procedures in patients presenting with solid tumors of the pankreas. J Gastrointest Surg 2013; 17 (7): 1218–1223. doi: 10.1007/s11605-013-2213-6.
24. Ryska M, Dušek L, Pohnán R et al. Kvalita života je důležitým faktorem indikační rozvahy u nemocných s karcinomem pankreatu. Multicentrická prospektivní studie. Gastroent Hepatol 2012; 66 (4): 303–310.

Kreditovaný autodidaktický test