Pankreaskrebs: Basler Expertise setzt neue weltweite Massstäbe
Researchers at the University Hospital Basel and Clarunis have defined international reference values for total pancreas removal for the first time in a large comparative study. Twenty-five leading medical centers, including the Mayo Clinic and Johns Hopkins Hospital, participated in the study under Basel's leadership and provided new insights that will set global standards.
2025-11-12, 10:00
More and more people are dying from pancreatic cancer. The United European Gastroenterology (UEG) describes pancreatic cancer as a “medical emergency in Europe.” It is responsible for the second-highest number of deaths from cancer of the digestive tract and has the lowest survival rate of all cancers in Europe.
Highly complex intervention with no reference values
A total pancreatectomy (TP) is necessary in cases of advanced pancreatic cancer or multifocal tumors. However, until now there has been a lack of internationally standardized reference data that would enable meaningful comparisons of the results achieved by different centers and hospitals. “Without internationally recognized reference values, clinics were unable to objectively classify their results”, explains study leader PD Dr. Philip C. Müller. Researchers at the University Hospital Basel (USB) and Clarunis have now examined surgical outcomes for the first time in an international study involving 25 centers.
Higher risks and unexpected death causes
Internationally renowned hospitals such as the Mayo Clinic and Johns Hopkins Hospital participated in the study led by Basel; data from a total of 994 patients was analyzed. The results of this study show that even under ideal conditions, the mortality rate for total removal is 6.3 percent—four times higher than for partial surgeries. If large blood vessels also have to be removed, mortality rises to almost 11 percent. Even without typical complications, these risks are higher than expected.
In addition, the most common causes of death were identified: septic shock (42 percent), bleeding (29 percent), and intestinal ischemia (14 percent).
Oncological advantage of radical tumor removal
Complete removal is associated with significantly higher complication rates than partial removal. However, long-term survival rates after total removal are comparable to those after partial removal, and the lymph node yield is even higher (29 vs. 16 nodes). “Radical removal could offer an oncological advantage in certain tumors”, says Prof. Beat Müller, Chief Physician of Visceral Surgery. However, this potential benefit must be carefully weighed against the increased risks.
This study was published in the scientific journal JAMA Surgery and will set global standards for one of the most demanding surgical procedures.
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