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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2015

01-06-2015 | Pancreatic Tumors

Additional Support for Neoadjuvant Therapy in the Management of Pancreatic Cancer

Authors: Kathleen K. Christians, MD, Douglas B. Evans, MD

Published in: Annals of Surgical Oncology | Issue 6/2015

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Excerpt

The relationship of a pancreatic head cancer to the superior mesenteric–portal vein (SMPV) confluence has intrigued and confused surgeons and oncologists for decades. The foundation for this ongoing debate began with Whipple, who described the operation of pancreaticoduodenectomy (PD) in 1935; Moore and colleagues, who first described resection and reconstruction of the superior mesenteric vein (SMV) in 1951; and Fortner, who reported his experience with regional pancreatectomy in 1973. Fortner routinely divided the distal splenic vein when performing segmental resection of the SMPV confluence, allowing for a primary end-to-end anastomosis of the SMV and portal vein (PV).1‐3 However, the failure of regional pancreatectomy to positively influence survival duration caused most to dismiss venous resection as an ineffective, high-risk, and therefore overaggressive approach to a disease that is often metastatic at diagnosis. …
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Fortner JG. Regional resection of cancer of the pancreas: a new surgical approach. Surgery. 1973;73:307–20.PubMed
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Fuhrman GM, Charnsangavej C, Abbruzzese JL, Martin RG, Fenoglio CF, Evans DB. Thin-section contrast enhanced computed tomography accurately predicts resectability of malignant pancreatic neoplasms. Am J Surg. 1994;167:104–13.CrossRefPubMed
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Tseng JF, Raut CP, Lee JE, et al. Pancreaticoduodenectomy with vascular resection: margin status and survival duration. J Gastrointest Surg. 2004;8:935–50.CrossRefPubMed
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Krepline AN, Christians KK, Duelge K, et al. Patency rates of portal vein/superior mesenteric vein reconstruction after pancreatectomy for pancreatic cancer. J Gastrointest Surg. 2014;18:2016–25.CrossRefPubMed
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Delpero JR, Boher JM, Sauvanet A, et al. Pancreatic adenocarcinoma with venous involvement: is up-front synchronous portal–superior mesenteric vein resection still justified? A survey of the Association Francaise de Chirurgie. Ann Surg Oncol. doi:10.​1245/​s10434-014-4304-3.
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Metadata
Title
Additional Support for Neoadjuvant Therapy in the Management of Pancreatic Cancer
Authors
Kathleen K. Christians, MD
Douglas B. Evans, MD
Publication date
01-06-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 6/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-4307-0

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