Surgical Treatment of Pancreatic Ductal Adenocarcinoma

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2021 Apr 30

PMID 33923884

Citations 16

Authors

Kongyuan Wei

Thilo Hackert

Affiliations

Soon will be listed here.

Abstract

Pancreatic ductal adenocarcinoma (PDAC) represents an aggressive tumor of the digestive system with still low five-year survival of less than 10%. Although there are improvements for multimodal therapy of PDAC, surgery still remains the effective way to treat the disease. Combined with adjuvant and/or neoadjuvant treatment, pancreatic surgery is able to enhance the five-year survival up to around 20%. However, pancreatic resection is always associated with a high risk of complications and regarded as one of the most complex fields in abdominal surgery. This review gives a summary on the surgical treatment for PDAC based on the current literature with a special focus on resection techniques.

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References

Murakami Y, Satoi S, Motoi F, Sho M, Kawai M, Matsumoto I . Portal or superior mesenteric vein resection in pancreatoduodenectomy for pancreatic head carcinoma. Br J Surg. 2015; 102(7):837-46. DOI: 10.1002/bjs.9799. View

Weitz J, Rahbari N, Koch M, Buchler M . The "artery first" approach for resection of pancreatic head cancer. J Am Coll Surg. 2010; 210(2):e1-4. DOI: 10.1016/j.jamcollsurg.2009.10.019. View

Oba A, Bao Q, Barnett C, Al-Musawi M, Croce C, Schulick R . Vascular Resections for Pancreatic Ductal Adenocarcinoma: Vascular Resections for PDAC. Scand J Surg. 2020; 109(1):18-28. DOI: 10.1177/1457496919900413. View

Varadhachary G, Tamm E, Abbruzzese J, Xiong H, Crane C, Wang H . Borderline resectable pancreatic cancer: definitions, management, and role of preoperative therapy. Ann Surg Oncol. 2006; 13(8):1035-46. DOI: 10.1245/ASO.2006.08.011. View

Hackert T, Werner J, Weitz J, Schmidt J, Buchler M . Uncinate process first--a novel approach for pancreatic head resection. Langenbecks Arch Surg. 2010; 395(8):1161-4. DOI: 10.1007/s00423-010-0663-9. View

Nakamura T, Asano T, Okamura K, Tsuchikawa T, Murakami S, Kurashima Y . A Preoperative Prognostic Scoring System to Predict Prognosis for Resectable Pancreatic Cancer: Who Will Benefit from Upfront Surgery?. J Gastrointest Surg. 2018; 23(5):990-996. DOI: 10.1007/s11605-018-3972-x. View

Moore G, Sako Y, THOMAS L . Radical pancreatoduodenectomy with resection and reanastomosis of the superior mesenteric vein. Surgery. 1951; 30(3):550-3. View

Yamamoto T, Satoi S, Kawai M, Motoi F, Sho M, Uemura K . Is distal pancreatectomy with en-bloc celiac axis resection effective for patients with locally advanced pancreatic ductal adenocarcinoma? -Multicenter surgical group study. Pancreatology. 2017; 18(1):106-113. DOI: 10.1016/j.pan.2017.11.005. View

Nguyen A, Melstrom L . Use of imaging as staging and surgical planning for pancreatic surgery. Hepatobiliary Surg Nutr. 2020; 9(5):603-614. PMC: 7603933. DOI: 10.21037/hbsn.2019.05.04. View

10.

APPLEBY L . The coeliac axis in the expansion of the operation for gastric carcinoma. Cancer. 1953; 6(4):704-7. DOI: 10.1002/1097-0142(195307)6:4<704::aid-cncr2820060410>3.0.co;2-p. View

11.

Delpero J, Sauvanet A . Vascular Resection for Pancreatic Cancer: 2019 French Recommendations Based on a Literature Review From 2008 to 6-2019. Front Oncol. 2020; 10:40. PMC: 7010716. DOI: 10.3389/fonc.2020.00040. View

12.

Sohal D, Duong M, Ahmad S, Gandhi N, Beg M, Wang-Gillam A . Efficacy of Perioperative Chemotherapy for Resectable Pancreatic Adenocarcinoma: A Phase 2 Randomized Clinical Trial. JAMA Oncol. 2021; 7(3):421-427. PMC: 7821078. DOI: 10.1001/jamaoncol.2020.7328. View

13.

Malinka T, Klein F, Andreou A, Pratschke J, Bahra M . Distal Pancreatectomy Combined with Multivisceral Resection Is Associated with Postoperative Complication Rates and Survival Comparable to Those After Standard Procedures. J Gastrointest Surg. 2018; 22(9):1549-1556. DOI: 10.1007/s11605-018-3804-z. View

14.

de Rooij T, van Hilst J, Van Santvoort H, Boerma D, van den Boezem P, Daams F . Minimally Invasive Versus Open Distal Pancreatectomy (LEOPARD): A Multicenter Patient-blinded Randomized Controlled Trial. Ann Surg. 2018; 269(1):2-9. DOI: 10.1097/SLA.0000000000002979. View

15.

Pedziwiatr M, Pisarska M, Malczak P, Major P, Wierdak M, Radkowiak D . Laparoscopic uncinate process first pancreatoduodenectomy-feasibility study of a modified 'artery first' approach to pancreatic head cancer. Langenbecks Arch Surg. 2017; 402(6):917-923. PMC: 5563330. DOI: 10.1007/s00423-017-1597-2. View

16.

Terasaki F, Fukami Y, Maeda A, Takayama Y, Takahashi T, Uji M . Comparison of end-to-end anastomosis and interposition graft during pancreatoduodenectomy with portal vein reconstruction for pancreatic ductal adenocarcinoma. Langenbecks Arch Surg. 2019; 404(2):191-201. DOI: 10.1007/s00423-019-01749-2. View

17.

Korrel M, Vissers F, van Hilst J, de Rooij T, Dijkgraaf M, Festen S . Minimally invasive versus open distal pancreatectomy: an individual patient data meta-analysis of two randomized controlled trials. HPB (Oxford). 2020; 23(3):323-330. DOI: 10.1016/j.hpb.2020.10.022. View

18.

Mora-Oliver I, Garces-Albir M, Dorcaratto D, Munoz-Forner E, Izquierdo Moreno A, Carbonell-Aliaga M . Pancreatoduodenectomy with artery-first approach. Minerva Chir. 2019; 74(3):226-236. DOI: 10.23736/S0026-4733.18.07944-0. View

19.

Melvin W, Needleman B, Krause K, Ellison E . Robotic resection of pancreatic neuroendocrine tumor. J Laparoendosc Adv Surg Tech A. 2003; 13(1):33-6. DOI: 10.1089/109264203321235449. View

20.

Aiolfi A, Lombardo F, Bonitta G, Danelli P, Bona D . Systematic review and updated network meta-analysis comparing open, laparoscopic, and robotic pancreaticoduodenectomy. Updates Surg. 2020; 73(3):909-922. PMC: 8184540. DOI: 10.1007/s13304-020-00916-1. View