title: Perioperative treatment options in resectable pancreatic cancer - how to improve long-term survival.
abstract: Surgery remains the only chance of cure for pancreatic cancer, but only 15%-25% of patients present with resectable disease at the time of primary diagnosis. Important goals in clinical research must therefore be to allow early detection with suitable diagnostic procedures, to further broaden operation techniques and to determine the most effective perioperative treatment of either chemotherapy and/or radiation therapy. More extensive operations involving extended pancreatectomy, portal vein resection and pancreatic resection in resectable pancreatic cancer with limited liver metastasis, performed in specialized centers seem to be the surgical procedures with a possible impact on survival. After many years of stagnation in pharmacological clinical research on advanced pancreatic ductal adenocarcinomas (PDAC) - since the approval of gemcitabine in 1997 - more effective cytotoxic substances (nab-paclitaxel) and combinations (FOLFIRINOX) are now available for perioperative treatment. Additionally, therapies with a broader mechanism of action are emerging (stroma depletion, immunotherapy, anti-inflammation), raising hopes for more effective adjuvant and neoadjuvant treatment concepts, especially in the context of "borderline resectability". Only multidisciplinary approaches including radiology, surgery, medical and radiation oncology as the backbones of the treatment of potentially resectable PDAC may be able to further improve the rate of cure in the future.
authors.affiliation: Marianne Sinn, Sue Travis, Uwe Pelzer, Hanno Riess, Department of Medical Oncology and Haematology, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany.
authors.forename: Marianne
authors.initials: M
authors.lastname: Sinn
authors.affiliation: Marianne Sinn, Sue Travis, Uwe Pelzer, Hanno Riess, Department of Medical Oncology and Haematology, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Bahra
authors.affiliation: Marianne Sinn, Sue Travis, Uwe Pelzer, Hanno Riess, Department of Medical Oncology and Haematology, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany.
authors.forename: Timm
authors.initials: T
authors.lastname: Denecke
authors.affiliation: Marianne Sinn, Sue Travis, Uwe Pelzer, Hanno Riess, Department of Medical Oncology and Haematology, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany.
authors.forename: Sue
authors.initials: S
authors.lastname: Travis
authors.affiliation: Marianne Sinn, Sue Travis, Uwe Pelzer, Hanno Riess, Department of Medical Oncology and Haematology, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Pelzer
authors.affiliation: Marianne Sinn, Sue Travis, Uwe Pelzer, Hanno Riess, Department of Medical Oncology and Haematology, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany.
authors.forename: Hanno
authors.initials: H
authors.lastname: Riess
keywords: Chemotherapy; Pancreatic cancer; Perioperative radiology; Perioperative treatment