[Surgical resection of pancreatic adenocarcinoma: indications and contraindications, pronostic factors and survival, recent advances].
The resection rate for pancreatic adenocarcinoma is only 10%. Curative resection remains the most important factor determining outcome for resectable pancreatic adenocarcinoma. Since 1990, an improvement on survival rate was observed, but the reasons are unclear: this improvement may be related to a more effective patient selection, more radical resection or adjuvant treatment strategies. The value of more radical resection remains open to debate, despite the negative results of two recent randomized trials with standard versus extended lymphadenectomy. The overall five-year survival rate after resection is still about 10% to 20%; these poor results emphasized the need for a best patient selection, the research of new preoperative prognostic factors, and randomized trials of neoadjuvant or adjuvant treatments.
Delpero
J R
JR
Département de chirurgie, institut Paoli-Calmettes, 232, boulevard de Sainte-Marguerite, 13009, Marseille, France. jrdelpero@wanadoo.fr
D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D020360:Neoadjuvant Therapy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D018579:Patient Selection; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013997:Time Factors