title: Surgery for advanced and metastatic pancreatic cancer--current state and trends.
abstract: Due to the late onset of symptoms in pancreatic cancer, patients are often presented with an already advanced or metastatic state of disease. Only in a minority of patients is a tumor resection indicated, e.g. in general tumor encasement of major vessels, while the presence of metastatic disease excludes patients from curative-intended surgery. Limitations for pancreatic resections have been debated and re-thought after more experience has gained over time. This holds true for en-bloc vascular resections, total pancreatectomies, intentional R2 pancreatic resections and synchronous resection of liver metastases. These issues are addressed in this review.
authors.affiliation: Department of General, Visceral and Thoracic Surgery, University Medical Center of Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. m.nentwich@uke.uni-hamburg.de
authors.forename: Michael F
authors.initials: MF
authors.lastname: Nentwich
authors.forename: Maximilian
authors.initials: M
authors.lastname: Bockhorn
authors.forename: Alexandra
authors.initials: A
authors.lastname: König
authors.forename: Jakob R
authors.initials: JR
authors.lastname: Izbicki
authors.forename: Güllü
authors.initials: G
authors.lastname: Cataldegirmen
mesh_terms: D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*