Pancreatic adenocarcinoma: ESMO–ESDO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Seufferlein, Thomas; Bachet, Jean‐Baptiste; Cutsem, E. Van; Rougier, Philippe

doi:10.1093/annonc/mds224

Cited by 331 publications

(260 citation statements)

References 37 publications

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“…[7] Adjuvant chemotherapy is indicated for all patients (including T1N0 disease) with pancreatic adenocarcinoma following resection. [8] Persistent elevation or rising Ca 19.9 after resection is associated with extremely poor prognosis. [9] However strong data is not available so that one can guide treatment decisions based on the finding of a persistently elevated Ca 19.9.…”

Section: Adjuvant Therapymentioning

confidence: 99%

“…[11] Randomized controlled clinical trials and meta-analyses suggest a significant OS benefit from chemotherapy alone following resection of a pancreatic cancer. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Current standard of care is Gemcitabine alone for 6 months postsurgery given the interpretations from the ESPAC-3 study which showed that though there was not a survival advantage with Gemcitabine compared to 5-FU, toxicities were significantly less with Gemcitabine. [16] Table 1 shows the key studies of adjuvant therapy in pancreatic cancer.…”

Section: Adjuvant Therapymentioning

confidence: 99%

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Advances in Chemotherapy for Pancreatic Cancer

Sirohi

Singh

Dawood

et al. 2015

Indian J Surg Oncol

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Section: Adjuvant Therapymentioning

confidence: 99%

Section: Adjuvant Therapymentioning

confidence: 99%

Advances in Chemotherapy for Pancreatic Cancer

Sirohi

Singh

Dawood

et al. 2015

Indian J Surg Oncol

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“…European groups emphasize the lack of significant benefit with chemoradiotherapy and hence recommend chemotherapy alone in the adjuvant setting and chemoradiotherapy is to be given only in the setting of a trial as per ESMO (European Society of Medical Oncology) [51]. The Americans on the other hand relying on the findings of GITSG study [47] advocate chemoradiotherapy.…”

Section: Adjuvant Treatmentmentioning

confidence: 99%

Improving Survival of Pancreatic Cancer. What Have We Learnt?

Singh

Chaudhary

2015

Indian J Surg

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Pancreatic adenocarcinoma still ranks high among cancer-related deaths worldwide. In spite of substantial strides in preoperative staging, surgery, perioperative care, and adjuvant treatment, the survival still remains dismal. A number of patient-, disease-, and surgeon-related factors play a role in deciding the eventual outcome of the patient. The aim of this commentary is to review the current knowledge of various factors and the recent advances that impact the survival of patients with pancreatic adenocarcinoma. A search of scientific literature using Embase and MEDLINE, for the years 1985-2015, was carried out for search terms Bpancreatic cancer^and Bsurvival.^Further search was based on the various specific prognostic factors that contribute towards survival of patients with pancreatic cancer found in the literature. Most of the studies used for this review include those that deal with pancreatic head cancers, some include patients with pancreatic cancers in all locations while very few included patients with tumors of body and tail only. In spite of significant developments in pre-and perioperative management, increased rates of margin-negative resections, and use of adjuvant treatment, the survival rates of pancreatic cancer patients remains poor. A paradigm shift with more effective adjuvant regimen and genetic interventions may help change the outcomes of patients with pancreatic cancer.

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“…• due to the low prevalence of PC, a screening program with the currently available technologies for the unselected population would only be cost-effective in people younger than 70 years who had a lifetime risk of PC ≥16% [13]; • computed tomography (CT) is not sensitive to detect small pancreatic lesions or their precursors [14]; • more sensitive technologies, such as endoscopic ultrasound, lack specificity to distinguish true early neoplasms from other benign changes of pancreatic structure [15,16]; and • no circulating biomarkers are validated for early diagnosis of PC [17,18].…”

mentioning

confidence: 99%