Timing of Pancreatic Resection and Patient Outcomes: Is There a Difference?

Rates of long-term survival after treatment of pancreatic cancer remain low, in part because most patients are still treated with primary resection. This approach is often inadequate because of early local control failures, early manifestation of metastatic disease because of the unrecognized and untreated systemic component of this disease, and because half of patients never receive multimodal therapy. Preoperative therapy can be used to improve local control and treat the systemic nature of pancreatic cancer while also selecting for patients who benefit from a morbid operation. Preoperative therapy makes sense for most patients with this aggressive and deadly disease.