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Updated: Aug 15, 2026
Laparoscopic Radical Antegrade Modular Pancreatosplenectomy via Dorsal-Caudal Artery Approach for Pancreatic Neck-Body Cancer
Published on: November 18, 2022
Modern management of pancreatic carcinoma
D Goldstein1, S Carroll, M Apte
1Department of Medical Oncology, Prince of Wales Hospital, New South Wales, Australia. d.goldstein@unsw.edu.au
Abstract:
Pancreatic cancer remains a fearsome disease. New insights into the molecular pathogenesis may influence choice of treatment modalities and provide avenues for novel therapeutic strategies for testing in the clinic. The survival rate of patients with all stages of disease is poor and clinical trials are appropriate alternatives for treatment and should be considered. Surgical resection, when possible, remains the primary treatment modality and can result in long-term cure. Less invasive techniques such as laparoscopy may reduce the rate of unnecessary laparotomies. The role of adjuvant therapy is re-emerging. Patients with unresectable and metastatic disease are incurable and optimal palliation is the goal. These patients may benefit from palliative bypass of biliary or duodenal obstruction if symptomatic. Pain associated with local tumour infiltration may be palliated with radiation, with or without chemotherapy, or with coeliac nerve blocks or local neurosurgical procedures. Chemotherapy with gemcitabine has modest objective response rates but has been shown to improve symptoms.
Insights
Pancreatic cancer has a poor survival rate, necessitating clinical trials for novel therapies. Surgical resection offers the best cure chance, while palliative care and chemotherapy like gemcitabine aim to improve symptoms for advanced stages.
Area of Science:
- Oncology
- Gastroenterology
Background:
- Pancreatic cancer presents significant challenges due to poor patient survival rates across all disease stages.
- Understanding the molecular pathogenesis is crucial for developing novel therapeutic strategies and improving treatment choices.
Purpose of the Study:
- To review current treatment modalities for pancreatic cancer.
- To highlight the importance of clinical trials for novel therapeutic strategies.
- To discuss palliative care options for unresectable and metastatic disease.
Main Methods:
- Review of existing literature on pancreatic cancer treatment.
- Discussion of surgical resection, adjuvant therapy, and palliative interventions.
- Evaluation of chemotherapy, specifically gemcitabine, for symptom management.
Main Results:
- Surgical resection is the primary curative treatment when feasible.
- Adjuvant therapy's role is being re-evaluated.
- Palliative bypass, radiation, chemotherapy, and nerve blocks can manage symptoms in advanced stages.
- Gemcitabine shows modest response rates and symptom improvement.
Conclusions:
- Clinical trials are vital for advancing pancreatic cancer treatment.
- Optimizing palliative care is essential for patients with incurable disease.
- Multimodal approaches combining surgery, adjuvant therapy, and palliative interventions are key.
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