[Evidence of Neoadjuvant Treatment for Pancreatic Cancer]

Several multicenter trials are in progressive regarding neoadjuvant treatment for pancreatic cancer to improve survival for pancreatic cancer. However, neoadjuvant treatment for pancreatic cancer is not yet standardized, although neoadjuvant treatment has gained increasing importance in recent years. No clear recommendation for any treatment standard is yet established. The potential advantages of neoadjuvant treatment are to deliver high dose intensity without the potential delays caused by surgical complications and delayed recovery or increase R0 rate. Additionally, neoadjuvant treatment may identify those patients with particularly aggressive disease, who would likely not benefit from resection. The disadvantages of neoadjuvant treatment are possibility of increasing postoperative outcomes or losing the chances for operations due to adverse effects of neoadjuvant treatment. Additionally, neoadjuvant treatment may cause metastasizing or becoming unresectable due to tumor progression during neoadjuvant treatment. Furthermore studies regarding neoadjuvant treatment for pancreatic cancer should be required to clarify as follows; patients selection to receive neoadjuvant treatment, selection of chemotherapy or radiochemotherapy as neoadjuvant treatment, appropriate regimens for neoadjuvant treatment, and appropriate periods for neoadjuvant treatment.