Therapy

Surgical removal of the tumor is the therapy of choice for papillary carcinoma. The tumor tissue at the papilla is cut out with a certain safety distance to the surrounding healthy tissue (excision), eventually the partial removal of the pancreas and the duodenum is also necessary. In the case of larger carcinomas, the entire head part of the pancreas including the gallbladder and the adjacent duodenum is removed (pancreatoduodenectomy according to Whipple).

To be on the safe side, the lymph nodes that supply the affected area are also removed. Normally, a surgical technique is chosen that allows the stomach to be preserved. Since important parts of the digestive system have nevertheless been removed, patients must undergo nutritional therapy after the operation to avoid complications.

Among other things, meals must be taken in several small portions spread over the day and should be low in fat. The digestive enzymes missing due to the removed pancreas must also be taken in tablet form. Patients in whom the papillary carcinoma has already progressed very far and who can therefore no longer be operated on can have a stent inserted into the draining bile or pancreatic ducts.

The stent allows the digestive secretion to drain off unhindered and the icterus to be removed. Although chemotherapy slows down the growth of papillary carcinoma, it does not provide a definitive cure. In addition to the sometimes very strong side effects, chemotherapy also has a low response rate in papillary carcinoma and is therefore only used for palliative purposes.

Prognosis – What is the life expectancy with a papillary carcinoma?

The prognosis and thus the life expectancy of a papillary carcinoma depend on the size of the tumor and the tumor stage. The tumor stage is determined by the so-called TNM classification and describes the type of tumor, its extent and whether lymph nodes are affected. The 5-year survival rate after successful surgical removal of the carcinoma is between 40 and 85%, depending on the exact location. If metastases have already formed in other parts of the body, the prognosis is worse.