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Conversion surgery for initially unresectable pancreatic cancer: current status and unresolved issues
Hideyuki Yoshitomi1, Shigetsugu Takano2, Katsunori Furukawa2
1Department of General Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan. yoshitomi@faculty.chiba-u.jp.
Surgery Today
|April 6, 2019
Summary
Conversion surgery offers hope for initially unresectable pancreatic cancer. Preoperative treatment like FOLFIRINOX can make advanced or metastatic disease operable, improving patient survival rates.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Pancreatic cancer has a dismal prognosis, often diagnosed at advanced stages.
- Conversion surgery is emerging for initially unresectable pancreatic cancer after preoperative treatment.
- FOLFIRINOX chemotherapy shows promise in enabling resection and improving outcomes.
Purpose of the Study:
- To review the current status of conversion surgery for unresectable pancreatic cancer.
- To highlight unresolved issues and future research directions in this field.
Main Methods:
- Review of current literature on conversion surgery for pancreatic cancer.
- Analysis of preoperative treatment regimens, including FOLFIRINOX.
- Evaluation of resection rates and survival outcomes.
Main Results:
- Resection rates of 6-44% reported with FOLFIRINOX for locally advanced pancreatic cancer.
- Median overall survival of 27-56 months observed in metastatic cases undergoing conversion surgery.
- Significant improvements in prognosis for selected patients.
Conclusions:
- Conversion surgery is a viable option for selected patients with initially unresectable pancreatic cancer.
- Further research is needed to optimize preoperative regimens and clarify the role of vascular resection.
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