title: Pancreatic cancer: progress made.
abstract: Pancreatic cancer remains a deadly disease. Despite advances on many fronts, surgeons play a leading role in the diagnosis and management of pancreatic cancer. Preoperative staging is best provided by "pancreas-protocol" abdominal CT, although endoscopic ultrasound and diagnostic laparoscopy can add value in selected patients. Surgical resection, which remains the only curative option, is now accomplished with uniformly low perioperative mortality in high-volume centers (<3%), although complications remain frequent. Unfortunately, the long-term prognosis for pancreatic cancer remains poor with 5-year survival rates only 15-23% with median survival of 13 to 18 months. Recent data from randomized trials have supported the role for adjuvant chemotherapy and questioned the traditional role of radiation. Early diagnosis and targeted multimodality treatments would appear essential to optimizing the results of surgical therapy.
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
authors.forename: Vlad V
authors.initials: VV
authors.lastname: Simianu
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Zyromski
authors.forename: Attila
authors.initials: A
authors.lastname: Nakeeb
authors.forename: Keith D
authors.initials: KD
authors.lastname: Lillemoe
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D000465:Algorithms; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D017024:Chemotherapy, Adjuvant; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D055088:Early Detection of Cancer; D019160:Endosonography; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007582:Jejunostomy; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods; D010180:Pancreatectomy / Q000379:methods / Q000401:mortality; D010190:Pancreatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D049268:Positron-Emission Tomography; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D014408:Biomarkers, Tumor; D003841:Deoxycytidine; D005472:Fluorouracil; D000093542:Gemcitabine