Influence of Resection Margins and Treatment on Survival in Patients With Pancreatic Cancer

Abstract

Pancreatic cancer remains a leading cause of cancer death in the Western world with about 31 000 and 65 000 deaths per year in the United States and Europe, respectively.^1-3 Curative resection of pancreatic cancer can be performed only in 10% to 15% of patients owing to advanced stage and an overall 5-year survival rate of about 10%.^1,2,4 Improvements in surgical technique have led to a significant reduction of perioperative morbidity and mortality in experienced centers in the subgroup of patients with resectable disease.^5-7 The role of adjuvant treatment, either as radiotherapy or chemotherapy, might further improve survival. The European Study Group for Pancreatic Cancer 1 (ESPAC-1) trial was the first study powered to evaluate the effects of both adjuvant radiotherapy and chemotherapy, concluding no survival benefit for chemoradiotherapy but a significant survival benefit for chemotherapy.^8,9