Systematic review of outcomes after distal pancreatectomy with coeliac axis resection for locally advanced pancreatic cancer

Klompmaker, Sjors; Rooij, Thijs de; Korteweg, Justine; Dieren, Susan van; Lienden, Krijn P. van; Gulik, Thomas M. van; Busch, Olivier R.; Besselink, Marc G.

doi:10.1002/bjs.10148

Cited by 69 publications

(54 citation statements)

References 42 publications

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“…With a comparable median survival of 18 months, especially adjuvant therapy was found to be a significant prognostic factor in the DP‐CAR collective. A recent systematic review on 19 studies included 240 patients and confirmed that, despite a considerable morbidity, this procedure can be performed with a low mortality of 3.5% and results in 15 months median survival, which increases to 18 months if resection is embedded in a multimodal therapy approach …”

Section: Neoadjuvant Therapy In Borderline Resectable Pancreatic Cancermentioning

confidence: 98%

Surgery for Pancreatic Cancer after neoadjuvant treatment

Hackert

2018

Annals of Gastroent Surgery

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Pancreatic ductal adenocarcinoma (PDAC) remains to be a therapeutic challenge as only 15%‐20% of all patients present with resectable tumor stages by the time of diagnosis. In the remaining patients, either local tumor extension or systemic spread are obstacles for a surgical therapy as the only chance for long‐term survival. With regard to local tumor extension, PDAC has been classified as resectable, borderline‐resectable (BR) or locally advanced (LA). While there is currently no evidence for neoadjuvant therapy in resectable PDAC, this issue remains controversial in BR‐PDAC. In the case of venous tumor involvement, guidelines mostly recommend upfront resection, when technically possible; whereas arterial involvement is regarded as an indication for chemotherapy or chemoradiotherapy first. Furthermore, in locally advanced PDAC, neoadjuvant treatment approaches have recently resulted in high rates of secondary resection, thus allowing “conversion” surgery in an otherwise palliative treatment situation. The present review gives an overview on the current literature of treatment concepts in these situations and additionally focuses of evaluation of resectability after neoadjuvant therapy as well as technical aspects in this specific situation.

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Section: Neoadjuvant Therapy In Borderline Resectable Pancreatic Cancermentioning

confidence: 98%

Surgery for Pancreatic Cancer after neoadjuvant treatment

Hackert

2018

Annals of Gastroent Surgery

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“…The frequency with which patients respond or remain with stable disease that can lead to resection is encouraging, but needs to be enhanced . A recent systematic review has confirmed the role of surgical therapy in which 19 studies involving 240 patients were included, which demonstrated a 18 (10‐26) month overall survival in the patients that were treated with neo‐adjuvant therapy …”

Section: Role Of Surgery—resection and Electroporationmentioning

confidence: 99%

“…[44][45] A recent systematic review has confirmed the role of surgical therapy in which 19 studies involving 240 patients were included, which demonstrated a 18 (10-26) month overall survival in the patients that were treated with neo-adjuvant therapy. 46…”

Section: Role Of Surgery-resection and Electroporationmentioning

confidence: 99%

Multi‐disciplinary management of locally advanced pancreatic cancer with irreversible electroporation

Martin

2017

Journal of Surgical Oncology

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The essential diagnosis for LAPC is based on high-quality cross-sectional imaging, which demonstrates tumor invasion into the celiac/superior mesenteric arteries and/or superior mesenteric/portal venous system that is not reconstructable. The optimal management of these patients is evolving quickly with the advent of newer chemotherapeutics, radiation, and non-thermal ablation modalities. This review will present the current status of initial chemotherapy, surgical therapy, ablative therapy, and radiation therapy for patients with nonmetastatic locally advanced unresectable pancreatic cancer.

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“…However, some surgical centers reported good outcomes after arterial resections (55), particularly for distal pancreatectomies with celiac axis resection (56,57).…”

Section: Borderline Resectable Pdacmentioning

confidence: 99%

Onco-surgical Strategies in Pancreatic Ductal Adenocarcinoma

Popescu¹,

Dumitraşcu²

2017

SGO

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Pancreatic ductal adenocarcinoma (PDAC) is an important healthcare problem because is a leading cause of death by cancer. PDAC is a highly lethal disease with a very dismal prognosis. Most patients present advanced disease at diagnosis. The management of a patient diagnosed with PDAC should be discussed in a multidisciplinary team in high-volume centers. Pancreatectomy represents the single hope of long-term survival for a patient with PDAC but the resectability rate is less than 20% of the cases. Several progresses were observed in the last years regarding the surgical and oncological approach for PDAC. The aim of the paper is to make a brief review of the current onco-surgical strategies available for patients with PDAC.

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Systematic review of outcomes after distal pancreatectomy with coeliac axis resection for locally advanced pancreatic cancer

Abstract: Distal pancreatectomy with coeliac axis resection seems a valuable option for selected patients with pancreatic cancer involving the coeliac axis with acceptable morbidity and mortality, and a median survival of 18 months when combined with (neo)adjuvant therapy.

Cited by 69 publications

References 42 publications

Surgery for Pancreatic Cancer after neoadjuvant treatment

Surgery for Pancreatic Cancer after neoadjuvant treatment

Multi‐disciplinary management of locally advanced pancreatic cancer with irreversible electroporation

Onco-surgical Strategies in Pancreatic Ductal Adenocarcinoma

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