Pancreatic Cancer: Advances in Treatment, Results and Limitations
- 1 June 2013
- journal article
- research article
- Published by S. Karger AG in Digestive Diseases
- Vol. 31 (1), 51-56
- https://doi.org/10.1159/000347178
Abstract
Background/Aims: Pancreatic cancer remains a therapeutic challenge. Surgery is the only treatment with the chance of cure. The aim of this review is to summarize the present state-of-the-art surgical procedures in pancreatic cancer. Methods: The current literature was reviewed with regard to surgical approaches in pancreatic cancer. A focus was put on high-quality studies, reviews, systematic reviews and meta-analyses as well as recruiting studies highlighting innovative approaches. Results: Today, standard resections can be performed with mortality rates below 5% in specialized high-volume institutions. Extended approaches for locally advanced cancer are technically feasible, including venous resections, multivisceral resections and recurrence surgery. They can be carried out without increased morbidity and mortality, are not compromised by higher R1 or N+ rates, and can improve survival. Arterial tumor invasion is still regarded controversially and is oncologically questionable. All surgical approaches should be part of interdisciplinary multimodal treatment concepts to improve the patients' prognosis. Conclusion: Surgery is the backbone of pancreatic cancer treatment in localized disease. Extended approaches are feasible in centers and show - except for arterial resections - good long-term outcome. Interdisciplinary therapy is an essential supplementation of all surgical approaches.Keywords
This publication has 39 references indexed in Scilit:
- Arterial Resection During Pancreatectomy for Pancreatic CancerAnnals of Surgery, 2011
- The “Artery First” Approach for Resection of Pancreatic Head CancerJournal of the American College of Surgeons, 2010
- Is pancreatectomy with arterial reconstruction a safe and useful procedure for locally advanced pancreatic cancer?Journal of Hepato-Biliary-Pancreatic Surgery, 2009
- Analysis of mortality rates for pancreatic cancer across the worldHPB, 2008
- Extended Appleby's operation for pancreatic cancer involving celiac axisJournal of Surgical Oncology, 2007
- Perioperative Mortality for PancreatectomyAnnals of Surgery, 2007
- Surgery for Recurrent Pancreatic Ductal AdenocarcinomaAnnals of Surgery, 2007
- Pancreatic Resection for M1 Pancreatic Ductal AdenocarcinomaAnnals of Surgical Oncology, 2006
- Hepatic Resection for Noncolorectal Nonendocrine Liver MetastasesTransactions of the ... Meeting of the American Surgical Association, 2006
- A Randomized Trial of Chemoradiotherapy and Chemotherapy after Resection of Pancreatic CancerThe New England Journal of Medicine, 2004