What Makes a Pancreatic Cancer Resectable? Am Soc Clin Oncol Educ Book 2018 May 23;38:300-305
Date
09/21/2018Pubmed ID
30231408DOI
10.1200/EDBK_200861Abstract
The majority of patients with localized pancreatic cancer who undergo surgery with or without adjuvant therapy will develop metastatic disease, suggesting that surgery alone is not sufficient for cure and micrometastases are present at the time of diagnosis even when not clinically apparent. As such, the field is rapidly moving to consensus on treatment sequencing, which emphasizes the early delivery of systemic therapy and the application of surgery to the population of patients most likely to receive clinical benefit from such large operations-namely, those with stable or responding disease following systemic therapy and often chemoradiation. There remains incomplete consensus about the definition of what is operable (both tumor anatomy and patient age/comorbidities) and whether the operation should be performed in a high-volume center by more experienced surgeons. In this article, we try to provide a comprehensive description of when surgery should be performed and what constitutes an operable tumor. Such information is critically important for the optimal delivery of stage-specific therapy and to allow physicians to provide accurate expectations to all patients for treatment outcome. The complex issues of where and by whom such large operations should be performed is beyond the scope of this review.
Author List
Evans DBAuthor
Douglas B. Evans MD Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Combined Modality TherapyHumans
Neoplasm Staging
Pancreatectomy
Pancreatic Neoplasms
Preoperative Care
Tomography, X-Ray Computed
Treatment Outcome
