Pancreatic Cancer: Advances in Treatment, Results and Limitations

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.

A targeting ligand enhances infectivity and cytotoxicity of an oncolytic adenovirus in human pancreatic cancer tissues

“…Pancreatic cancer is the leading cause of cancer death, and it is considered one of the most lethal cancers in Japan as well as in the Western countries [1][2][3]. Despite the recent advances in therapeutic and diagnostic modalities [4,5], overcoming it remains one of the most formidable challenges in oncology today.…”

“…In the locally advanced cases also, the development of strategies to strongly control local lesions and prevent distant metastases is an important issue. In spite of the fact that many studies have been tried to improve the outcomes, a novel approach is needed [3,5].…”

Surgical Options for Chronic Visceral Abdominal Pain

“…The pancreatic exocrine and endocrine function is signifi cantly reduced. Contemporary series show the procedure can be performed with low mortality (0-5 %) in experienced centers, but the morbidity 20-40 % remains high [ 12 ].…”

A mathematical model for pancreatic cancer growth and treatments

“…Currently surgery remains the treatment approach with the best chance of cure, but only localized cancer is suitable for surgical intervention. Furthermore only about 20% of patients present with localized disease at the time of diagnosis (Koido et al, 2011; Hackert and Büchler, 2013). The most common histologic subtype of pancreatic cancer, which is the subject of this paper, is pancreatic ductal adenocarcinoma.…”