Pancreatic cancer historical perspective
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]
Overview
Pancreatic cancer was first discovered in the 18th-century by Italian scientist Giovanni Battista Morgagni.
Historical Perspective
- The history of the pancreatic cancer is as follows:[1][2][3][4][5]
- Another series of 2,050 operations at the Massachusetts General Hospital between 1941 and 2011 showed a similar picture of improvement.
- In 2010, the WHO recommended that PanNETs be referred to as "neuroendocrine" rather than "endocrine" tumors.
- The earliest recognition of pancreatic cancer has been attributed to the 18th-century Italian scientist Giovanni Battista Morgagni,
- Morgagni is the historical father of modern-day anatomic pathology, who claimed to have traced several cases of cancer in the pancreas.
- Many 18th and 19th-century physicians were skeptical about the existence of the disease, given the similar appearance of pancreatitis.
- Some case reports were published in the 1820s and 1830s, and a genuine histopathologic diagnosis was eventually recorded by the American clinician Jacob Mendes Da Costa, who also doubted the reliability of Morgagni's interpretations.
- By the start of the 20th century, cancer of the head of the pancreas had become a well-established diagnosis.
- Regarding the recognition of PanNETs, the possibility of cancer of the islet cells was initially suggested in 1888.
- The first case of hyperinsulinism due to a tumor of this type was reported in 1927.
- Recognition of a non-insulin-secreting type of PanNET is generally ascribed to the American surgeons, R. M. Zollinger and E. H. Ellison, who gave their names to Zollinger–Ellison syndrome, after postulating the existence of a gastrin-secreting pancreatic tumor in a report of two cases of unusually severe peptic ulcers published in 1955.
- The first reported partial pancreaticoduodenectomy was performed by the Italian surgeon Alessandro Codivilla in 1898, but the patient only survived 18 days before succumbing to complications.
- Early operations were compromised partly because of mistaken beliefs that people would die if their duodenum was removed, and also, at first, if the flow of pancreatic juices stopped.
- Later it was thought that the pancreatic duct could simply be tied up without serious adverse effects; in fact it will very often leak later on.
- In 1907-08, after some more unsuccessful operations by other surgeons, experimental procedures were tried on corpses by French surgeons.
- In 1912 the German surgeon Walther Kausch was the first to remove large parts of the duodenum and pancreas together (en bloc) in Breslau, now Wrocław in Poland.
- In 1918 it was demonstrated in operations on dogs that total removal of the duodenum is compatible with life, but this was not reported in human surgery until 1935, when the American surgeon Allen Old father Whipple published the results of a series of three operations at Columbia Presbyterian Hospital in New York.
- Only one of the patients had the duodenum totally removed, but he survived for two years before dying of metastasis to the liver.
- The first operation was unplanned, as cancer was only discovered in the operating theater.
- Whipple's success showed the way for the future, but the operation remained a difficult and dangerous one until recent decades. He published several refinements to his procedure, including the first total removal of the duodenum in 1940, but he only performed a total of 37 operations.
- The discovery in the late 1930s that vitamin K prevented bleeding with jaundice, and the development of blood transfusion as an everyday process, both improved post-operative survival.
- In 1970s a group of American surgeons wrote urging that the procedure was too dangerous and should be abandoned.
- Since then outcomes in larger centers have improved considerably, and mortality from the operation is often less than 4%.
- One type, the intraductal papillary mucinous neoplasm (IPMN) was first described by Japanese researchers in 1982; "For the next decade, little attention was paid to this report; however, over the subsequent 15 years, there has been a virtual explosion in the recognition of this tumor.
- In 2006 a report was published on a series of 1,000 consecutive pancreaticoduodenectomies performed by a single surgeon from Johns Hopkins Hospital between 1969 and 2003.
- The rate of these operations had increased steadily over this period, with only three of them before 1980, and the median operating time reduced from 8.8 hours in the 1970s to 5.5 hours in the 2000s, and mortality within 30 days or in hospital was only 1%.
- Small precancerous neoplasms for many pancreatic cancers are being detected at greatly increased rates by modern medical imaging.
References
- ↑ Busnardo AC, DiDio LJ, Tidrick RT, Thomford NR (1983). "History of the pancreas" (PDF). American Journal of Surgery. 146 (5): 539–50. doi:10.1016/0002-9610(83)90286-6. PMID 6356946.
- ↑ Are C, Dhir M, Ravipati L (June 2011). "History of pancreaticoduodenectomy: early misconceptions, initial milestones and the pioneers". HPB : the official journal of the International Hepato Pancreato Biliary Association. 13 (6): 377–84. doi:10.1111/j.1477-2574.2011.00305.x. PMID 21609369.
- ↑ Cameron JL, Riall TS, Coleman J, Belcher KA (July 2006). "One thousand consecutive pancreaticoduodenectomies". Annals of surgery. 244 (1): 10–5. doi:10.1097/01.sla.0000217673.04165.ea. PMID 16794383.
- ↑ Klimstra DS, Modlin IR, Coppola D, Lloyd RV, Suster S (2010). "The pathologic classification of neuroendocrine tumors: a review of nomenclature, grading, and staging systems". Pancreas. 39 (6): 707–12. doi:10.1097/MPA.0b013e3181ec124e. PMID [ 20664470 [ Check
|pmid=value (help). - ↑ Fernández-del Castillo C, Morales-Oyarvide V, McGrath D, Wargo JA, Ferrone CR, Thayer SP, Lillemoe KD, Warshaw AL (September 2012). "Evolution of the Whipple procedure at the Massachusetts General Hospital". Surgery. 152 (3 Suppl 1): S56–63. doi:10.1016/j.surg.2012.05.022. PMC 3806095. PMID 22770961.