Multimodality Therapy in Patients With Borderline Resectable or Locally Advanced Pancreatic Cancer: Importance of Locoregional Therapies for a Systemic Disease. J Oncol Pract 2016 Oct;12(10):915-923
Date
11/20/2016Pubmed ID
27858562DOI
10.1200/JOP.2016.016162Scopus ID
2-s2.0-84991252464 (requires institutional sign-in at Scopus site) 20 CitationsAbstract
Historically, the clinical staging of pancreatic cancer has centered on the surgical management of the primary tumor, because few effective chemotherapeutic agents were available and long-term survival was only achieved in the context of surgical resection. Such a strategy of complete oncologic surgical care is reasonable when surgery is both the principal therapy and highly effective. However, complex surgery for pancreatic cancer-often performed in older patients after a lengthy period of induction therapy-can be associated with significant morbidity and mortality. The majority of patients with pancreatic cancer present either locally advanced or metastatic disease at the time of diagnosis. In this article, we will discuss the role of multimodality management of patients with borderline resectable and locally advanced pancreatic cancer. Considering that surgery has a modest impact on the natural history of pancreatic cancer in most patients, a neoadjuvant approach to treatment sequencing is favored for patients with borderline resectable pancreatic cancer, and this same rationale has been extended to select patients with locally advanced disease who demonstrate an exceptional response to induction therapy.
Author List
Tsai S, Christians KK, Ritch PS, George B, Khan AH, Erickson B, Evans DBAuthors
Kathleen K. Christians MD Professor in the Surgery department at Medical College of WisconsinBeth A. Erickson MD Professor in the Radiation Oncology department at Medical College of Wisconsin
Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of Wisconsin
Ben George MD Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Combined Modality TherapyElectrochemotherapy
Humans
Margins of Excision
Neoplasm Staging
Pancreatic Neoplasms
