title: Pancreatic cancer--low survival rates.
abstract: BACKGROUND
  Cancers of the pancreas are identified in 11 800 to 13 500 patients each year in Germany. Epidemiological studies prove smoking and chronic alcohol consumption as causes of about 30% of pancreatic cancers.
  
  
  METHODS
  Selective literature review.
  
  
  RESULTS
  Only patients within TNM stage I and II have after oncologic tumor extirpation a chance for long term survival. Controlled prospective clinical trials demonstrated adjuvant chemotherapy yielding an additional significant survival benefit. The 3- and 5-year-survival after R0-resection and adjuvant chemotherapy are about 30% and below 15% respectively. Using the criteria of observed 5-year-survival less than 2% of all pancreatic cancer patients are alive. After R0-resection the median survival time is between 17 and 28 months, after R1/2-resection between 8 and 22 months.
  
  
  CONCLUSIONS
  Pancreatic cancer is even today for more than 95% of the patients incurable. Strategies to prevent pancreatic cancer are intended to stop smoking and chronic alcohol consumption and early surgical extirpation of cystic neoplastic lesions. For patients with established pancreatic cancer risk a follow-up protocol is discussed.
authors.affiliation: Abteilung für Allgemein- und Viszeralchirurgie, Klinikum der Universität Ulm, Steinhövelstrasse 9, Ulm, Germany. hans.beger@medizin.uni-ulm.de
authors.forename: Hans G
authors.initials: HG
authors.lastname: Beger
authors.forename: Bettina
authors.initials: B
authors.lastname: Rau
authors.forename: Frank
authors.initials: F
authors.lastname: Gansauge
authors.forename: Gerd
authors.initials: G
authors.lastname: Leder
authors.forename: Michael
authors.initials: M
authors.lastname: Schwarz
authors.forename: Bertram
authors.initials: B
authors.lastname: Poch