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Current state of surgical management of pancreatic cancer.

Hackert T, Büchler MW, Werner J - Cancers (Basel) (2011)

Bottom Line: Pancreatic surgery is a technically challenging procedure and has significantly changed during the past decades with regard to technical aspects as well as perioperative care.Furthermore, there is growing evidence that also more extended resections including multivisceral approaches, vessel reconstructions or surgery for tumor recurrence can be carried out safely with favorable outcomes.The impact of adjuvant treatment, especially chemotherapy, has increased dramatically within recent years, leading to significantly improved postoperative survival, making pancreatic cancer therapy an interdisciplinary approach to achieve best results.

View Article: PubMed Central - PubMed

Affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. thilo_hackert@med.uni-heidelberg.de.

ABSTRACT
Pancreatic cancer is still associated with a poor prognosis and remains-as the fourth leading cause of cancer related mortality-a therapeutic challenge. Overall long-term survival is about 1-5%, and in only 10-20% of pancreatic cancer patients is potentially curative surgery possible, increasing five-year survival rates to approximately 20-25%. Pancreatic surgery is a technically challenging procedure and has significantly changed during the past decades with regard to technical aspects as well as perioperative care. Standardized resections can be carried out with low morbidity and mortality below 5% in high volume institutions. Furthermore, there is growing evidence that also more extended resections including multivisceral approaches, vessel reconstructions or surgery for tumor recurrence can be carried out safely with favorable outcomes. The impact of adjuvant treatment, especially chemotherapy, has increased dramatically within recent years, leading to significantly improved postoperative survival, making pancreatic cancer therapy an interdisciplinary approach to achieve best results.

No MeSH data available.


Related in: MedlinePlus

CT scan showing pancreatic head cancer with infiltration of the celiac trunk. Infiltration of common hepatic, left gastric and splenic artery (white circle, left, middle and right vessel). Technically not resectable finding.
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f3-cancers-03-01253: CT scan showing pancreatic head cancer with infiltration of the celiac trunk. Infiltration of common hepatic, left gastric and splenic artery (white circle, left, middle and right vessel). Technically not resectable finding.

Mentions: In contrast to venous tumor adhesion, arterial infiltration of the celiac axis (Figure 3) or the superior mesenteric artery must be regarded as a symptom of biologically aggressive tumor spread. Therefore, decision to perform a surgical resection in this situation is a highly individual decision. The resection of the celiac axis or the superior mesenteric artery has been performed since the 1970s in selected patients but is still regarded as an extraordinary approach in PDAC surgery [62-65].


Current state of surgical management of pancreatic cancer.

Hackert T, Büchler MW, Werner J - Cancers (Basel) (2011)

CT scan showing pancreatic head cancer with infiltration of the celiac trunk. Infiltration of common hepatic, left gastric and splenic artery (white circle, left, middle and right vessel). Technically not resectable finding.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3756412&req=5

f3-cancers-03-01253: CT scan showing pancreatic head cancer with infiltration of the celiac trunk. Infiltration of common hepatic, left gastric and splenic artery (white circle, left, middle and right vessel). Technically not resectable finding.
Mentions: In contrast to venous tumor adhesion, arterial infiltration of the celiac axis (Figure 3) or the superior mesenteric artery must be regarded as a symptom of biologically aggressive tumor spread. Therefore, decision to perform a surgical resection in this situation is a highly individual decision. The resection of the celiac axis or the superior mesenteric artery has been performed since the 1970s in selected patients but is still regarded as an extraordinary approach in PDAC surgery [62-65].

Bottom Line: Pancreatic surgery is a technically challenging procedure and has significantly changed during the past decades with regard to technical aspects as well as perioperative care.Furthermore, there is growing evidence that also more extended resections including multivisceral approaches, vessel reconstructions or surgery for tumor recurrence can be carried out safely with favorable outcomes.The impact of adjuvant treatment, especially chemotherapy, has increased dramatically within recent years, leading to significantly improved postoperative survival, making pancreatic cancer therapy an interdisciplinary approach to achieve best results.

View Article: PubMed Central - PubMed

Affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. thilo_hackert@med.uni-heidelberg.de.

ABSTRACT
Pancreatic cancer is still associated with a poor prognosis and remains-as the fourth leading cause of cancer related mortality-a therapeutic challenge. Overall long-term survival is about 1-5%, and in only 10-20% of pancreatic cancer patients is potentially curative surgery possible, increasing five-year survival rates to approximately 20-25%. Pancreatic surgery is a technically challenging procedure and has significantly changed during the past decades with regard to technical aspects as well as perioperative care. Standardized resections can be carried out with low morbidity and mortality below 5% in high volume institutions. Furthermore, there is growing evidence that also more extended resections including multivisceral approaches, vessel reconstructions or surgery for tumor recurrence can be carried out safely with favorable outcomes. The impact of adjuvant treatment, especially chemotherapy, has increased dramatically within recent years, leading to significantly improved postoperative survival, making pancreatic cancer therapy an interdisciplinary approach to achieve best results.

No MeSH data available.


Related in: MedlinePlus