Pancreatic cancer and liver metastases: state of the art.
Pancreatic cancer is still one of the most aggressive oncological diseases with a 5-year mortality rate below 10%. Surgery remains the only curative treatment; however, most patients present with late-stage disease deemed unresectable, either due to extensive local vascular involvement or the presence of distant metastasis. In the detection of hepatic metastases, the current standard is palliative chemotherapy with fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) or nab-paclitaxel with gemcitabine. Once hepatic metastases are diagnosed, the guidelines do not recommend resection of the primary tumor. Recent findings suggest that some patients with non-resectable diseases initially have survival rates as good as those with initially resectable disease when they are able to undergo surgical resection. Synchronous resection of both the primary tumour as well as the liver metastases may be beneficial and improves the outcome.
Department of General, Visceral and Thoracic SurgeryUniversity Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20249, Hamburg, Germany.
Eugen
E
Bellon
Department of General, Visceral and Thoracic SurgeryUniversity Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20249, Hamburg, Germany.
Florian
F
Gebauer
Department of General, Visceral and Thoracic SurgeryUniversity Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20249, Hamburg, Germany.
Michael
M
Tachezy
Department of General, Visceral and Thoracic SurgeryUniversity Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20249, Hamburg, Germany.
Jakob R
JR
Izbicki
Department of General, Visceral and Thoracic SurgeryUniversity Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20249, Hamburg, Germany. M.bockhorn@uke.de.
Maximilian
M
Bockhorn
D000970:Antineoplastic Agents / Q000627:therapeutic use; D014943:Global Health; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology / Q000556:secondary / Q000628:therapy; D009017:Morbidity / Q000639:trends; D010166:Palliative Care / Q000379:methods*; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy; D015996:Survival Rate / Q000639:trends
D000970:Antineoplastic Agents
Liver metastasis; Palliative chemotherapy; Pancreatic adenocarcinoma; Synchronous resection