Pancreatic Cancer: Who Benefits from Curative Resection?

Surgical resection is the only chance for cure of pancreatic cancer. Unfortunately, the majority of patients have grossly unresectable disease. Patients with stage I or II disease according to the criteria of the International Union Against Cancer (UICC) should be considered for potentially curative...

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Main Authors: HG Beger, F Gansauge, G Leder
Format: Article
Language:English
Published: Wiley 2002-01-01
Series:Canadian Journal of Gastroenterology
Online Access:http://dx.doi.org/10.1155/2002/174320
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author HG Beger
F Gansauge
G Leder
author_facet HG Beger
F Gansauge
G Leder
author_sort HG Beger
collection DOAJ
description Surgical resection is the only chance for cure of pancreatic cancer. Unfortunately, the majority of patients have grossly unresectable disease. Patients with stage I or II disease according to the criteria of the International Union Against Cancer (UICC) should be considered for potentially curative surgery. The goal of surgery is to remove the entire tumour with no residual disease (oncological R0 resection), which requires extensive resection of the surrounding tissues. Even if lymph nodes are histologically free of disease, molecular biological techniques reveal infiltration with cancer cells in 50% of cases. Therefore, extensive local resection combined with radical resection of lymphatic tissue, including lymph nodes around the head of the pancreas, retroperitoneal tissue and neural plexus around the great vessels, affords a longer median survival time than standard resection alone. Even patients with UICC stage III disease can undergo aggressive surgical treatment, but their chances for long term survival are low. Some patients develop severe diarrhea after circumferential removal of nerve tissue around the superior mesenteric artery. Adjuvant radiochemotherapy also provides a modest prolongation of survival. Despite these advances, the prognosis for pancreatic cancer is still poor, and spread of tumour within the peritoneum and to the liver is common postoperatively.
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spelling doaj-art-66bd5ce750824700a3d6276bc419bec42025-02-03T01:27:34ZengWileyCanadian Journal of Gastroenterology0835-79002002-01-0116211712010.1155/2002/174320Pancreatic Cancer: Who Benefits from Curative Resection?HG Beger0F Gansauge1G Leder2Department of General Surgery, University of Ulm, Ulm, GermanyDepartment of General Surgery, University of Ulm, Ulm, GermanyDepartment of General Surgery, University of Ulm, Ulm, GermanySurgical resection is the only chance for cure of pancreatic cancer. Unfortunately, the majority of patients have grossly unresectable disease. Patients with stage I or II disease according to the criteria of the International Union Against Cancer (UICC) should be considered for potentially curative surgery. The goal of surgery is to remove the entire tumour with no residual disease (oncological R0 resection), which requires extensive resection of the surrounding tissues. Even if lymph nodes are histologically free of disease, molecular biological techniques reveal infiltration with cancer cells in 50% of cases. Therefore, extensive local resection combined with radical resection of lymphatic tissue, including lymph nodes around the head of the pancreas, retroperitoneal tissue and neural plexus around the great vessels, affords a longer median survival time than standard resection alone. Even patients with UICC stage III disease can undergo aggressive surgical treatment, but their chances for long term survival are low. Some patients develop severe diarrhea after circumferential removal of nerve tissue around the superior mesenteric artery. Adjuvant radiochemotherapy also provides a modest prolongation of survival. Despite these advances, the prognosis for pancreatic cancer is still poor, and spread of tumour within the peritoneum and to the liver is common postoperatively.http://dx.doi.org/10.1155/2002/174320
spellingShingle HG Beger
F Gansauge
G Leder
Pancreatic Cancer: Who Benefits from Curative Resection?
Canadian Journal of Gastroenterology
title Pancreatic Cancer: Who Benefits from Curative Resection?
title_full Pancreatic Cancer: Who Benefits from Curative Resection?
title_fullStr Pancreatic Cancer: Who Benefits from Curative Resection?
title_full_unstemmed Pancreatic Cancer: Who Benefits from Curative Resection?
title_short Pancreatic Cancer: Who Benefits from Curative Resection?
title_sort pancreatic cancer who benefits from curative resection
url http://dx.doi.org/10.1155/2002/174320
work_keys_str_mv AT hgbeger pancreaticcancerwhobenefitsfromcurativeresection
AT fgansauge pancreaticcancerwhobenefitsfromcurativeresection
AT gleder pancreaticcancerwhobenefitsfromcurativeresection