title: [Prediction of prognosis of pancreatic cancer based on the homing area].
abstract: The homing area is a genetically defined location where primary malignancy originates and local recurrences occur. In order to be completely successful, curative resections of malignant tumors have to eradicate the homing area. This is possible in colon resection where the borders of the homing area are distant from the tumor and the lymph nodes can easily be resected to remove possible node metastases. In contrast, the homing area of the pancreas comprises only the gland itself, similar to all other glandular organs. The high specificity of the homing area is demonstrated by the finding that even pancreatic islets are spared by the malignant disease. During fetal development the pancreas loses most of the original dorsal and ventral mesentery. Via short lymphatic pathways, metastatic cells leave the gland in a centrifugal manner and find their way to regional lymph nodes that often share drainage with other neighboring organs. The lymph nodes are arranged in multiple layers and not in flat mesentery-like structures. Radical resections are therefore difficult to achieve.
authors.affiliation: Chirurgische Universitätsklinik, Sigmund-Freud-Str. 25, 53127, Bonn-Venusberg, Deutschland. Stel33345@aol.com
authors.forename: F
authors.initials: F
authors.lastname: Stelzner
authors.forename: J
authors.initials: J
authors.lastname: Ruhlmann
authors.forename: D
authors.initials: D
authors.lastname: von Mallek
mesh_terms: D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D018450:Disease Progression; D005205:Fascia / Q000196:embryology / Q000473:pathology; D000071938:Fasciotomy; D006801:Humans; D007515:Islets of Langerhans / Q000196:embryology / Q000473:pathology / Q000601:surgery; D008197:Lymph Node Excision / Q000379:methods; D008207:Lymphatic Metastasis / Q000473:pathology*; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000196:embryology / Q000473:pathology* / Q000601:surgery*; D049268:Positron-Emission Tomography; D011379:Prognosis; D012086:Reoperation; D014057:Tomography, X-Ray Computed