Radical resection for pancreatic cancer

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Pancreatic ductal adenocarcinoma presents significant challenges with poor surgical prognosis and difficulties in early detection.
• Existing treatments often fall short, necessitating advancements in surgical techniques and diagnostic methods.

Purpose of the Study:

• To improve survival rates for pancreatic cancer through enhanced surgical procedures and chemotherapy.
• To develop more effective methods for the early diagnosis and precise localization of occult pancreatic lesions.

Main Methods:

• Extended pancreatectomy involving extensive lymphatic and connective tissue clearance was performed.
• Liver perfusion chemotherapy was administered via the hepatic artery and portal vein.
• Active pancreatic juice collection for cytodiagnosis and intraoperative cytology were employed for lesion localization.

Main Results:

• Extended pancreatectomy increased the 5-year survival rate from 8% to 24% by reducing locoregional recurrence.
• Combined extended pancreatectomy and liver perfusion chemotherapy further elevated the 5-year survival rate to 40% by decreasing hepatic metastasis.
• Intraoperative cytology enabled precise localization of occult lesions, leading to a 100% disease-free 5-year survival rate in cases with early-stage or minimally invasive carcinoma.

Conclusions:

• A balanced treatment approach focusing on locoregional control and prevention of hepatic metastasis is crucial for pancreatic cancer.
• Intraoperative cytology is a valuable tool for diagnosing and surgically managing early-stage pancreatic cancer.
• Future research should focus on identifying high-risk patients and developing less invasive methods for pancreatic juice collection.