Advances in Surgery and (Neo) Adjuvant Therapy in the Management of Pancreatic Cancer

Hematol Oncol Clin North Am. 2024 Jun;38(3):629-642. doi: 10.1016/j.hoc.2024.01.004. Epub 2024 Feb 29.

Abstract

A multimodality approach, which usually includes chemotherapy, surgery, and/or radiotherapy, is optimal for patients with localized pancreatic cancer. The timing and sequence of these interventions depend on anatomic resectability and the biological suitability of the tumor and the patient. Tumors with vascular involvement (ie, borderline resectable/locally advanced) require surgical reassessments after therapy and participation of surgeons familiar with advanced techniques. When indicated, venous reconstruction should be offered as standard of care because it has acceptable morbidity. Morbidity and mortality of pancreas surgery may be mitigated when surgery is performed at high-volume centers.

Keywords: Adjuvant therapy; Borderline-resectable; Locally-advanced; Neoadjuvant therapy; Pancreatectomy; Pancreatic cancer; Resectability.

Publication types

  • Review

MeSH terms

  • Combined Modality Therapy
  • Disease Management
  • Humans
  • Neoadjuvant Therapy*
  • Pancreatectomy / methods
  • Pancreatic Neoplasms* / mortality
  • Pancreatic Neoplasms* / pathology
  • Pancreatic Neoplasms* / surgery
  • Pancreatic Neoplasms* / therapy