Pankreasın Malign Tümörleri
Özet
Pankreas kanseri, oldukça ölümcül ve agresif doğası nedeniyle küresel ölçekte kritik bir sağlık yükü oluşturmaya devam etmektedir. Modern tıp teknolojisindeki gelişmelere rağmen, erken teşhisin zorluğu ve hastaların büyük kısmının ileri evrede başvurması nedeniyle beş yıllık sağkalım oranı %10 civarındadır. Büyük çoğunluğunu duktal adenokarsinomların oluşturduğu bu hastalıkta, sigara, obezite, diyabet ve kronik pankreatit en önemli değiştirilebilir risk faktörleridir. Klinik olarak sarılık, karın ağrısı ve kilo kaybı klasik semptomlar olup, rutin olarak onaylanan tek biyobelirteç CA 19-9'dur. Teşhis ve evrelemede BT, MRG, MRCP ve ERCP gibi ileri kesitsel görüntüleme yöntemlerinden yararlanılmaktadır. Cerrahi rezeksiyon günümüzde halen tek potansiyel küratif tedavi seçeneğidir; tümörün konumuna göre Whipple prosedürü veya distal pankreatektomi ameliyatları uygulanır. Ameliyat sonrası dönemde kemoterapinin eklenmesi sağkalımı olumlu etkilerken, lokal ileri veya uzak metastatik hastalık durumlarında sistemik kemoterapi temel tedavi yöntemidir.
Pancreatic cancer remains a critical global health burden due to its highly aggressive nature and dismal survival rates. Despite advancements in modern medical technology, the 5-year survival rate is only around 10% because early diagnosis is challenging and most patients present with advanced or metastatic disease. While ductal adenocarcinomas constitute the majority of cases, smoking, obesity, diabetes, and chronic pancreatitis represent the key modifiable risk factors. Clinically, the disease presents with classic symptoms such as jaundice, abdominal pain, and weight loss, with CA 19-9 serving as the only FDA-approved biomarker. Diagnosis and staging rely heavily on cross-sectional imaging modalities including CT, MRI, MRCP, and ERCP. Surgical resection remains the only potential curative treatment option, utilizing either the Whipple procedure or distal pancreatectomy depending on the tumor location. Adjuvant chemotherapy significantly improves survival rates, whereas systemic chemotherapy stands as the primary intervention for patients with locally advanced or distant metastatic disease.
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