BACKGROUND: Pancreatic cancer carries a dismal prognosis but there has been a vast increase in evidence on its management in the past decade. METHODS: An electronic and manual search was performed for articles on the surgical treatment of pancreatic cancer published in the past 10 years. RESULTS: Six major areas of advancement were identified. Groups at high risk of developing pancreatic cancer, notably those with chronic pancreatitis and hereditary pancreatitis, have been defined, raising the need for secondary screening. Methods of staging pancreatic cancer for resection have greatly improved but accuracy is still only 85-90 per cent. Pylorus-preserving partial pancreatoduodenectomy without extended lymphadenectomy is the simplest procedure; it does not compromise long-term survival. Adjuvant chemotherapy significantly improves long-term survival. Patients who are free from major co-morbidity have better palliation by surgery (with a double bypass) than by endoscopy. High-volume centres improve the results of surgery for all outcome measures including long-term survival. CONCLUSION: The surgical management of pancreatic cancer has undergone a significant change in the past decade. It has moved away from no active treatment. The standard of care can now be defined as potentially curative resection in a specialist centre followed by adjuvant systemic chemotherapy. Copyright (c) 2004 British Journal of Surgery Society Ltd
BACKGROUND:Pancreatic cancer carries a dismal prognosis but there has been a vast increase in evidence on its management in the past decade. METHODS: An electronic and manual search was performed for articles on the surgical treatment of pancreatic cancer published in the past 10 years. RESULTS: Six major areas of advancement were identified. Groups at high risk of developing pancreatic cancer, notably those with chronic pancreatitis and hereditary pancreatitis, have been defined, raising the need for secondary screening. Methods of staging pancreatic cancer for resection have greatly improved but accuracy is still only 85-90 per cent. Pylorus-preserving partial pancreatoduodenectomy without extended lymphadenectomy is the simplest procedure; it does not compromise long-term survival. Adjuvant chemotherapy significantly improves long-term survival. Patients who are free from major co-morbidity have better palliation by surgery (with a double bypass) than by endoscopy. High-volume centres improve the results of surgery for all outcome measures including long-term survival. CONCLUSION: The surgical management of pancreatic cancer has undergone a significant change in the past decade. It has moved away from no active treatment. The standard of care can now be defined as potentially curative resection in a specialist centre followed by adjuvant systemic chemotherapy. Copyright (c) 2004 British Journal of Surgery Society Ltd
Authors: Phillip J Gray; Jingya Wang; Timothy M Pawlik; Barish H Edil; Richard Schulick; Ralph H Hruban; Harry Dao; John Cameron; Christopher Wolfgang; Joseph M Herman Journal: J Surg Oncol Date: 2012-02-03 Impact factor: 3.454
Authors: Jörg-Christian Heinrich; Anne Tuukkanen; Michael Schroeder; Torsten Fahrig; Rudolf Fahrig Journal: J Cancer Res Clin Oncol Date: 2011-07-22 Impact factor: 4.553