Optimizing the outcomes of pancreatic cancer surgery

Strobel, Oliver; Neoptolemos, John; Jäger, Dirk; Büchler, Markus W.

doi:10.1038/s41571-018-0112-1

Cited by 943Pancreatic and Hepatic Oncology ResearchPancreatitis Pathology and TreatmentCholangiocarcinoma and Gallbladder Cancer Studies

Optimizing the outcomes of pancreatic cancer surgery

Strobel, Oliver, Neoptolemos, John, Jäger, Dirk, Büchler, Markus W.·2019·Nature Reviews Clinical Oncology

DOI 10.1038/s41571-018-0112-1

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Abstract

Pancreatic cancer is likely to become the second most frequent cause of cancer-associated mortality within the next decade. Surgical resection with adjuvant systemic chemotherapy currently provides the only chance of long-term survival. However, only 10-20% of patients with pancreatic cancer are diagnosed with localized, surgically resectable disease. The majority of patients present with metastatic disease and are not candidates for surgery, while surgery remains underused even in those with resectable disease owing to historical concerns regarding safety and efficacy. However, advances made over the past decade in the safety and efficacy of surgery have resulted in perioperative mortality of around 3% and 5-year survival approaching 30% after resection and adjuvant chemotherapy. Furthermore, owing to advances in both surgical techniques and systemic chemotherapy, the indications for resection have been extended to include locally advanced tumours. Many aspects of pancreatic cancer surgery, such as the management of postoperative morbidities, sequencing of resection and systemic therapy, and use of neoadjuvant therapy followed by resection for tumours previously considered unresectable, are rapidly evolving. In this Review, we summarize the current status of and new developments in pancreatic cancer surgery, while highlighting the most important research questions for attempts to further optimize outcomes.

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Authors: Strobel, O., Neoptolemos, J., Jäger, D., & Büchler, M. W.
Affiliations: University Hospital Heidelberg (DE)
Heidelberg University (DE)
Corresponding author: Büchler, Markus W.
ORCID: Strobel, Oliver
Neoptolemos, John
Büchler, Markus W.
Venue: Nature Reviews Clinical Oncology
Publisher: Springer Science and Business Media LLC
Published: 2018-10-19
Volume: 16
Issue: 1
Pages: 11-26
ISSN: 1759-4774 (ISSN-L)
1759-4782
DOI: 10.1038/s41571-018-0112-1
OpenAlex: W2897346547
Cited by: 943
References: 134
Citations by year: 2026: 73 · 2025: 130 · 2024: 131 · 2023: 165 · 2022: 166 · 2021: 141 · 2020: 91 · 2019: 43 · 2018: 2
FWCI: 7.30
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Nature Reviews Clinical Oncology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
Health Sciences › Medicine › Surgery › Cholangiocarcinoma and Gallbladder Cancer Studies
Keywords: pancreatic cancer, pancreatic resection, adjuvant chemotherapy, neoadjuvant therapy, perioperative mortality, postoperative morbidity, locally advanced cancer, unresectable tumors, surgical indications
MeSH terms: Combined Modality Therapy, Humans, Neoplasm Metastasis, Pancreatic Neoplasms, Postoperative Complications, Digestive System Surgical Procedures, Survival Analysis, Treatment Outcome, Chemotherapy, Adjuvant

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