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[Conversion Surgery for Pancreatic Cancer].

Masanori Horikawa¹, Mina Fukasawa, Juri Machi

¹Dept. of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama.

Gan to Kagaku Ryoho. Cancer & Chemotherapy

|February 17, 2025

Summary

Pancreatic cancer, often diagnosed at advanced stages, now sees more unresectable cases treated with conversion surgery. This multidisciplinary approach offers new hope for locally advanced and metastatic pancreatic cancer patients.

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Robot Assisted Distal Pancreatectomy with Celiac Axis Resection DP-CAR for Pancreatic Cancer: Surgical Planning and Technique

Published on: August 14, 2021

Area of Science:

Oncology
Surgical Oncology
Gastroenterology

Context:

Pancreatic cancer has a poor prognosis, with most cases advanced at diagnosis.
Multidisciplinary treatments are improving outcomes for unresectable pancreatic cancer.
The 8th edition of the General Rules for Study of Pancreatic Cancer introduced "conversion surgery" for unresectable cases.

Purpose:

To review the evolving role and current controversies of conversion surgery for unresectable pancreatic cancer.
To assess the potential benefits and risks of conversion surgery in locally advanced (UR-LA) and metastatic (UR-M) pancreatic cancer.
To explore the implications of positive peritoneal washing cytology (CY1) in the context of conversion surgery.

Summary:

Advances in chemotherapy, radiation, and heavy-ion therapy enable surgery for previously unresectable pancreatic cancer.
Conversion surgery is increasingly reported for UR-LA and UR-M pancreatic cancer, but indications and outcomes remain debated.
Positive peritoneal cytology (CY1) is now classified as distant metastasis, with potential for CY-negative conversion offering prognostic benefits.

Impact:

Conversion surgery represents a paradigm shift in managing advanced pancreatic cancer.
Further research is needed to establish clear guidelines and evidence for conversion surgery's efficacy and safety.
This evolving strategy may improve survival and quality of life for select pancreatic cancer patients.