New Surgical Strategies in Treatment of Cancer Pancreas

Abstract

Summary R esection remains the only chance for a cure of pancreatic adenocarcinoma, and most resectable patients should undergo surgery without delay, followed by adjuvant therapy. Borderline respectable patients and select resectable patients can undergo neoadjuvant therapy in the hopes of improving the chances for an R0 resection or can immediately undergo surgery. Salvage therapy is an option for those patients whose disease recurs following surgery. Patients with locally advanced unresectable disease and good performance status can undergo chemotherapy and chemoradiation with second-line therapy if performance status is maintained after progression. Good performance status patients presenting with metastatic disease can undergo chemotherapy and can undergo second-line therapy if performance status is maintained after progression. Specific palliative measures are recommended for patients with advanced pancreatic adenocarcinoma characterized by biliary or gastric obstruction, severe abdominal pain, or other tumor-associated manifestations of the disease.