Erschienen in:
01.09.2014 | Pancreatic Tumors
More Harm than Good?
verfasst von:
Jennifer L. Gnerlich, MD, Mitchell C. Posner, MD
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 9/2014
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Excerpt
Despite all the research-driven “breakthroughs” in the management of pancreatic cancer, the one constant for patients to have any chance at achieving long-term survival is that they are able to undergo resection with curative intent. It is also evident from data generated from phase III randomized trials that chemotherapy (with or without radiation) delivered in the adjuvant setting improves survival in this highly lethal cancer. Surgery followed by chemotherapy or chemoradiotherapy is considered the standard of care for most patients. Yet, considering the extent of surgery necessary to achieve a negative margin resection for cancer of the head of the pancreas, initiating or completing this standard treatment sequence is unfortunately not straightforward. Pancreaticoduodenectomy (PD) is known to be associated with one of the highest postoperative complication rates, up to and exceeding 50 % in many series, even in the most experienced surgical hands at high-volume centers. So, this begs the question: what is the impact of surgical complications on the receipt and timing of adjuvant therapy post-PD? …
