[Treatment of pancreatic cancer--surgical point of view]

Although surgical techniques for pancreatic cancer have developed in a high level, the treatment results have not been improved and the 5 year survival rates after curative operation has been about 15% in Japan. Retrospective studies on extended lymphadenectomy for ductal adenocarcinoma of the head of the pancreas revealed that extended surgery prolonged the survival for resected patients. These studies have been reported mainly from Japan and followed by similar retrospective studies from Japan and European countries which showed same advantageous results in extended lymphadenectomy or did not reveal any advantages in this aggressive approach. Finally, the clinical advantages of extended lymphadenectomy for pancreatic cancer was denied by several RCTs from Italy and U.S.A. Although usefulness of radio/chemotherapy has been controversial, adjuvant chemotherapy with gemcitabin significantly prolonged the patients' survival after curative pancreatectomy. Further development of multidisciplinary treatments for pancreatic cancer is expected.