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Surgery Today
Published in: Surgery Today 11/2019

01-11-2019 | Pancreatic Cancer | Review Article

Conversion surgery for initially unresectable pancreatic cancer: current status and unresolved issues

Authors: Hideyuki Yoshitomi, Shigetsugu Takano, Katsunori Furukawa, Tsukasa Takayashiki, Satoshi Kuboki, Masayuki Ohtsuka

Published in: Surgery Today | Issue 11/2019

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Abstract

Pancreatic cancer is one of the most lethal of all malignancies. One of the reasons for the dismal prognosis is that most diagnoses are made when the disease is either locally advanced or metastatic. Recent advances in chemotherapy and chemoradiotherapy (CRT) enable “conversion surgery” to be performed for selected patients with initially unresectable pancreatic cancer following favorable responses to preoperative treatment. Using FOLFIRINOX as preoperative treatment, the resection rate was reported as 6–44% of patients with locally advanced cancer and the prognosis of these patients was favorable. Even for metastasized cancer, recent reports show the effectiveness of conversion surgery, which has achieved 27–56 months of median overall survival. However, there are many unanswered questions about conversion surgery. The optimal regimen and duration of preoperative treatment remain unclear and there is still debate regarding the safety and effectiveness of vascular resection, which is often required for curative resection of locally advanced cancer. Accumulation of more data on conversion surgery is required to establish the safety and effectiveness of this treatment. In this review, we summarize the current status and unresolved issues about conversion surgery for initially unresectable pancreatic cancer.
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Metadata
Title
Conversion surgery for initially unresectable pancreatic cancer: current status and unresolved issues
Authors
Hideyuki Yoshitomi
Shigetsugu Takano
Katsunori Furukawa
Tsukasa Takayashiki
Satoshi Kuboki
Masayuki Ohtsuka
Publication date
01-11-2019
Publisher
Springer Singapore
Published in
Surgery Today / Issue 11/2019
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-019-01804-x

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Verification of T descriptor with consolidation size for sub-centimeter non-small cell lung cancer

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A novel device designed to improve the operability of energy devices with foot pedals in endoscopic surgery: the Foot-Site Monitor

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Is laparoscopic colorectal surgery with continuation of antiplatelet therapy safe without increasing bleeding complications?

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The prognostic significance of the comprehensive complication index in patients with gastric cancer

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Recombinant human soluble thrombomodulin reduces the severity and incidence of necrotizing enterocolitis in a newborn rat model