title: [Surgical treatment of carcinoma of the pancreas].
abstract: Invasive ductal carcinoma of the pancreas (pancreatic cancer) is mainly treated by operative resection, radio-chemotherapy, or chemotherapy. The survival rate of the patients with each treatment is not good when compared with that in other cancers. Meanwhile, it is still true that surgical resection remains the only method offering pancreatic cancer patients long-term survival or cure. The indications for surgical resection should be considered based on whether margin-free resection can be achieved in individual patients. In addition, the volume of pancreatic cancer patients treated at the institution and the surgeon's personal experience may greatly affect the decision. A recent randomized clinical trial from Japan revealed that surgical resection has a survival advantage over chemo-radiation therapy for locally advanced pancreatic cancer, which is defined as stage IVa in the fourth Japanese edition of the Classification of Pancreatic Carcinoma. Moreover, guidelines for clinical practice for pancreatic cancer by the Japan Pancreas Society have been issued very recently. In addition, the surgical indications should be reevaluated in combination with the adjuvant or neoadjuvant chemotherapy in future.
authors.affiliation: Department of Surgery, Kyoto University, Kyoto, Japan.
authors.forename: Ryuichiro
authors.initials: R
authors.lastname: Doi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kami
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ito
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Yoshida
mesh_terms: D044584:Carcinoma, Ductal / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D006801:Humans; D009367:Neoplasm Staging; D010180:Pancreatectomy / Q000379:methods; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate