Current Status of Surgery for Pancreatic Cancer

Abstract

Background: In Japan the annual incidence of pancreatic cancer has increased over the last decade, but no advancement has been made in the long-term prognosis after resection. The significant differences in the surgical procedures between Western countries and Japan have been discussed. Therefore, an adequate comparison and analysis of the data from Japan, Europe and the USA is required. This review evaluates many important published reports from Japan which influence surgical procedure. Methods: Several important highlights and controversies regarding the concept of surgical treatment and surgical procedure are discussed comparing the results in Japan with those in Western countries. Results: No significant difference in diagnostic strategy using various imaging methods was observed between Japan and Europe. The stage classification for pancreatic cancer by the Japanese Pancreatic Society (JPS) seems to be superior to others, because the results on long-term prognosis after pancreatectomy of cases with pancreatic head cancer, diagnosed as tubular adenocarcinoma, has been arranged logically. Pancreatectomy with extended radical dissection is recommended in Japan, but several clinical studies from Europe and the USA suggest that this is ineffective. The basic concepts of this controversy have recently come closer altogether. Scientific clinical trials for instance on the necessity of adjuvant treatment, etc., are now on-going. Conclusion: The characteristics on diagnosis and treatment of pancreatic cancer in Japan are described. The JPS registration system for pancreatic cancer can provide much more information, i.e. dependency on diagnostic methods, highly frequent sites of lymph node and of distant metastases, the prognosis of small pancreatic cancers, etc. The indication for any surgical treatments should be limited to cases with the possibility of cancer free margins.

MiR-221 Promotes Capan-2 Pancreatic Ductal Adenocarcinoma Cells Proliferation by Targeting PTEN-Akt

“…The prognosis of patients with PDAC is one of the worst in all cancer forms, despite that medical advances have been made in tumor diagnosis and treatment strategies during the past decades [43]. Consequently, it is of great importance to develop novel therapeutic methods to treat patients suffered from PDAC.…”

Changes in the expression of serum markers CA242, CA199, CA125, CEA, TNF-α and TSGF after cryosurgery in pancreatic cancer patients

“…Pancreatic cancer (PC) is one of the most lethal malignancies (Michalski et al 2007), and the 5 year survival rate for PC patients is less than 5 % (Hirata et al 2007). Due to a lack of easily observable symptoms, patients cannot be diagnosed at an early stage and therefore less than 20 % of PC patients are candidates for surgical resection.…”

High EGFR mRNA expression is a prognostic factor for reduced survival in pancreatic cancer after gemcitabine-based adjuvant chemotherapy

“…Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal and aggressive human malignancies, and it is the fourth leading cause of tumor-related deaths in the industrialized world (1,2). The vast majority of patients with PDAC have poor outcomes due to the aggressive nature of the tumor and difficulties in early diagnosis due to the lack of early diseasespecific signs and symptoms.…”