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An Orthotopic Resectional Mouse Model of Pancreatic Cancer
Published on: September 24, 2020
Technical Implications for Surgical Resection in Locally Advanced Pancreatic Cancer
Martín de Santibañes1, Juan Pekolj1, Rodrigo Sanchez Claria2
1Liver Transplant Unit, Department of Surgery, Division of HPB Surgery, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, Buenos Aires C1181ACH, Argentina.
Abstract:
Pancreatic ductal adenocarcinoma remains a global health challenge and is predicted to soon become the second leading cause of cancer death in developed countries. Currently, surgical resection in combination with systemic chemotherapy offers the only chance of cure or long-term survival. However, only 20% of cases are diagnosed with anatomically resectable disease. Neoadjuvant treatment followed by highly complex surgical procedures has been studied over the last decade with promising short- and long-term results in patients with locally advanced pancreatic ductal adenocarcinoma (LAPC). In recent years, a wide variety of complex surgical techniques that involve extended pancreatectomies, including portomesenteric venous resection, arterial resection, or multi-organ resection, have emerged to optimize local control of the disease and improve postoperative outcomes. Although there are multiple surgical techniques described in the literature to improve outcomes in LAPC, the comprehensive view of these strategies remains underdeveloped. We aim to describe the preoperative surgical planning as well different surgical resections strategies in LAPC after neoadjuvant treatment in an integrated way for selected patients with no other potentially curative option other than surgery.
Insights
Pancreatic cancer surgery is improving for locally advanced cases. Complex surgical techniques and neoadjuvant treatment offer new hope for patients with initially unresectable pancreatic ductal adenocarcinoma.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Pancreatic ductal adenocarcinoma is a leading cause of cancer death globally.
- Currently, only 20% of patients have resectable disease at diagnosis.
- Neoadjuvant therapy followed by surgery shows promise for locally advanced pancreatic ductal adenocarcinoma (LAPC).
Purpose of the Study:
- To provide a comprehensive overview of surgical planning and resection strategies for LAPC.
- To integrate current knowledge on advanced surgical techniques for LAPC.
- To guide selected patients with no other curative options towards surgery.
Main Methods:
- Review of existing literature on surgical techniques for LAPC.
- Description of preoperative surgical planning considerations.
- Analysis of complex surgical resections including portomesenteric venous and arterial resection.
Main Results:
- Emergence of complex pancreatectomies to improve local disease control.
- Advancements in surgical techniques aim to enhance postoperative outcomes.
- A growing body of evidence supports neoadjuvant treatment followed by surgery for LAPC.
Conclusions:
- Surgical management of LAPC is evolving with complex techniques.
- Integrated preoperative planning is crucial for successful outcomes.
- Advanced surgical resection strategies offer a potentially curative option for selected LAPC patients.
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