Pankreasın Malign Tümörleri
Özet
Pankreasın malign tümörlerini ele alan bu çalışma, hastalığın epidemiyolojisini, risk faktörlerini ve tedavi yöntemlerini kapsamlı bir şekilde incelemektedir. Dünyada mortalite oranı en yüksek 7. kanser türü olan pankreas kanseri, özellikle Batı ülkelerinde artış eğilimindedir. Yaş, erkek cinsiyet, Afro-Amerikan köken ve aile öyküsü değiştirilemeyen temel risk faktörleriyken; sigara kullanımı, obezite, kronik pankreatit ve yüksek alkol tüketimi en önemli değiştirilebilir etkenler olarak öne çıkmaktadır. Tümörlerin %90'ını ekzokrin kökenli duktal adenokanserler oluşturur. Hastalık genellikle spesifik olmayan semptomlar nedeniyle ileri evrede teşhis edilmekte ve vakaların büyük çoğunluğu tanı anında inoperabl kabul edilmektedir. Karın ağrısı, obstrüktif sarılık ve kilo kaybı tipik klinik bulgulardır. Tek küratif seçenek cerrahi müdahale (Whipple, distal veya total pankreatektomi) olup, adjuvan kemoterapi ile sağkalım oranları artırılmaya çalışılmaktadır. Ayrıca, insülinoma ve gastrinoma gibi daha nadir görülen ve farklı klinik tablolarla seyreden nöroendokrin tümörlerin de tanı ve tedavi süreçleri dokümanda detaylandırılmıştır.
This study on malignant tumors of the pancreas comprehensively examines the epidemiology, risk factors, and treatment methods of the disease. Pancreatic cancer, which is the 7th most common cause of cancer-related mortality worldwide, shows an increasing trend especially in Western countries. While age, male gender, African-American ethnicity, and family history are the primary non-modifiable risk factors; smoking, obesity, chronic pancreatitis, and high alcohol consumption stand out as the most significant modifiable factors. Exocrine-derived ductal adenocarcinomas constitute 90% of the tumors. The disease is generally diagnosed at an advanced stage due to non-specific symptoms, and the vast majority of cases are considered inoperable at the time of diagnosis. Abdominal pain, obstructive jaundice, and weight loss are typical clinical findings. Surgery (Whipple, distal, or total pancreatectomy) is the only curative option, and survival rates are attempted to be increased with adjuvant chemotherapy. Additionally, the diagnosis and treatment processes of rarer neuroendocrine tumors, such as insulinoma and gastrinoma, which present with different clinical pictures, are detailed in the document.
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