OnkoZentrum Zürich

Mr S., 69 years

OnkoZentrum Zürich

Pancreatic Cancer pT3pN1cMO G2

• 6/07 Whipple operation, R1• 8/07-4/08 palliative chemotherapy with gemcitabine, side effects:

• capillary leak• renal insuffiency

• 12/08 new lesion in segment VI of the liver, no local recurrence • 12/08 hospitalisation with sepsis (positiv blood cultures) but otherwise good good performance status

• art. hypertension• chronic renal insufficiency (GFR 20ml/min), proteinuria, hyperphosphataemia• hypothyroidosis• peripheral neuropathy

OnkoZentrum Zürich

MRI Abdomen 3.12.08

OnkoZentrum Zürich

Mr S., 69 years

Questions to the panel:

Should this patient receive chemotherapy or radiotheray or both ?

What kind of chemotherapy (renal insuffiency) ?

Is an operation of the liver lesion justified ?