Mitchell Cancer Institute, University of South Alabama. Mobile, AL, USA

Resectable Pancreatic Cancer: Is Surgery the Best First Step?

Suzanne Russo, John Chabot, Muhammad Wasif Saif

Abstract


 

Controversy exist regarding the potential benefit of the neoadjuvant approach to pancreatic cancer as limited retrospective data exists comparing pre- with post-operative chemoradiation. The optimal treatment approach remains unclear as we await prospective randomized clinical trials evaluating the hypothesized benefit of the neoadjuvant therapy for resectable pancreatic cancer and as there has been no proven survival benefit to date. Here we summarize the data presented at the 2012 American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium providing additional insight into the potential of neoadjuvant therapy in the treatment of pancreatic cancer. (Abstracts #156, #162, #168 and #177).

 


Keywords


Laparoscopy; Neoadjuvant Therapy; Pancreatic Neoplasms; Proteomics

References


Evans, D.B., T.A. Rich, D.R. Byrd, et al. Preoperative chemoradiation and pancreaticoduodenectomy for adenocarcinoma of the pancreas. Arch Surg, 1992. 127(11): 1335-1339.

Evans, D.B., G.R. Varadhachary, C.H. Crane, et al. Preoperative gemcitabine-based chemoradiation for patients with resectable adenocarcinoma of the pancreatic head .J Clin Oncol, 2008. 26(21): 3496-3502.

Varadhachary, G.R., R.A. Wolff, C.H. Crane, et al. Preoperative gemcitabine and cisplatin followed by gemcitabine-based chemoradiation for resectable adenocarcinoma of the pancreatic head. J Clin Oncol, 2008. 26(21): 3487-3495.

Gillen, S., T. Schuster, C. Meyer Zum Buschenfelde, et al. Preoperative/neoadjuvant therapy in pancreatic cancer: a systematic review and meta-analysis of response and resection percentages. PLoS Med, 2010. 7(4): e1000267.

Hohenberger W. Gemcitabine, Cisplatin, and Radiation Therapy Followed By Surgery or Surgery Alone in Treating Patients With Localized Pancreatic Cancer That Can Be Removed By Surgery. In: National Cancer Institute, ClinicalTrials.gov: NCT00335543.

Abbott DE, Tzeng C-W D, Merkow RP, Cantor SB, Katz MHG, Bentrem DJ, Bilimoria KY, Crane CH, Varadhachary GR, Fleming JB. Neoadjuvant chemoradiation versus surgery first for resectable pancreatic head adenocarcinoma: An economic and outcome analysis. J Clin Oncol 30, 2012 (suppl 4; abstr 156)

Santoro PM, Abdel-Misih RZ, Petrelli NJ, Bennett JJ. Is laparoscopy still needed for staging resectable pancreatic cancer? J Clin Oncol 30, 2012 (suppl 4; abstr 168)

Chen KT, Singla S, Papavasiliou P, Devarajan K, Hoffman JP. Revisiting the prognostic significance of positive peritoneal cytology in pancreatic cancer. J Clin Oncol 30, 2012 (suppl 4; abstr 177)

Brand R, Buchholz M, Mehan M, Whitcomb DC, Zeh H, Moser AJ, Gress TM, Williams S, dela Cruz M, Ostroff R. Detection of resectable pancreatic cancer with SOMAmer proteomic technology. J Clin Oncol 30, 2012 (suppl 4; abstr 162)

Klinkenbijl JH, Jeekel J, Sahmoud T et al. Adjuvant radiotherapy and 5-fluorouracil after curative resection of cancer of the pancreas and periampullary region: phase III trial of the EORTC gastrointestinal tract cancer cooperative group. Ann Surg1999. 230: 776-82; discussion 782-4.

Cheng TY, Sheth K, White RR et al. Effect of neoadjuvant chemoradiation on operative mortality and morbidity for pancreaticoduodenectomy. Ann Surg Oncol 2006. 13: 66-74.


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