Onkológia 5/2022

Current trends in the surgical treatment of pancreatic cancer

Pancreatic ductal adenocarcinoma (PDAC) represents 90% of all pancreatic tumours. It has a dismal prognosis with a 5 year overall survival rate less than 10%. The multidisciplinary collaboration in the specialized centers is necessary for the effective treatment of patients with PDAC. The progress of surgical techniques and perioperative care with the management of postoperative complications has brought an improvement into the perioperative mortality, which was historically around 80% and nowadays is reduced below 5% in the specialized centers. Even though, there is an improvement in the surgical outcomes, the much anticipated long term results for the survival of these patients have not improved much. The novel therapeutic strategies and focus on early diagnosis with the active surveillance of the individuals at risk will be the cornerstone of improved oncological long term results. This review summarizes the current state of surgical treatment of pancreatic cancer with its pitfalls, including neoadjuvant treatment, vascular resection, extended resection, role of extended lymphadenectomy with a glimpse into the minimally invasive surgery of pancreatic carcinoma.

Keywords: pancreatic carcinoma, vascular resection, extended resection, minimally invasive pancreatic surgery, lymphadenectomy, neoadjuvant treatment, pancreatectomy