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Pancreatic tumor enucleations can be carried out with good results and no mortality. Decisions regarding enucleations are highly individual compared to standard resections, underlining the importance of treatment in experienced high-volume institutions. Enucleations should be carried out whenever possible and oncologically feasible to prevent the typical complications of major pancreatic resection.

ancreatic cancer is characterized by aggressive tumor growth with early metastases (1, 2). Further, cancer cachexia and sarcopenia are both ubiquitous characteristics which limit the ability to perform daily activities, compromise patients' quality of life (QoL), and have been associated with poor overall survival (3,4). Therefore, preservation of physical functioning and health-related QoL are the main treatment goals of supportive cancer care.Patient QoLvaries significantly depending on stage of disease and treatment phase. Thus, patients in a metastatic disease situation were found to have a lower QoL compared to surgically treated patients (5). Furthermore, patients shortly after surgery have a lower QoL than patients at two months after surgery SummaryBackground: Improving quality of life (QoL) is an important treatment goal in pancreatic cancer patients. Although the beneficial effects of exercise on QoL are well understood, few studies have investigated more aggressive cancers such as pancreatic cancer.Methods: Within a randomized trial, we assessed the efficacy of 6-month resistance training on physical functioning (primary outcome) and further QoL-related outcomes. 65 pancreatic cancer patients were assigned to home-based training, supervised training, or a usual care control group. Analysis-of-covariance models on changes from baseline to 6 and 3 months were applied.Results: 47 patients completed the intervention period. After 6 months, no effects of resistance training were observed. However, after 3 months, explorative analyses showed significant between-group mean differences (MD) in favor for resistance training for physical functioning (pooled group: MD=11.0; p=0.016; effect size[ES]=0.31), as well as for global QoL (MD=12.1; p=0.016; effect size=0.56), and other outcomes, such as sleep problems and fatigue. Multiple imputation analyses yielded similar results. Home-based and supervised training performed similarly. Conclusion:This first randomized resistance training trial in pancreatic cancer patients indicated clinically relevant improvements in QoL after 3 but not after 6 months. Given the severity of pancreatic cancer, exercise recommendations may already commence at surgery.