Surgery and Multimodal Treatments in Pancreatic Cancer. A Review on the Basis of Future Multimodal Treatment Concepts.
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Accession number;99A0203850
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| Title;Surgery and Multimodal Treatments in Pancreatic Cancer. A Review on the Basis of Future Multimodal Treatment Concepts. |
| Author;
LINK K H
(Univ. Ulm, Ulm, Deu)
LEDER G
(Univ. Ulm, Ulm, Deu)
FORMENTINI A
(Univ. Ulm, Ulm, Deu)
FRTNAGEL G
(Univ. Ulm, Ulm, Deu)
KORNMANN M
(Univ. Ulm, Ulm, Deu)
SCHATZ M
(Univ. Ulm, Ulm, Deu)
BEGER H G
(Univ. Ulm, Ulm, Deu)
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Journal Title;Japanese Journal of Cancer and Chemotherapy
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Journal Code:Z0938A
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ISSN:0385-0684
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VOL.26;NO.1;PAGE.10-40(1999)
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| Figure&Table&Reference;TBL.4, REF.111 |
| Pub. Country;Japan |
| Language;English |
| Abstract;Background: To improve the surgical outcome after resection of pancreatic adenocarcinomas, multimodal treatment concepts need to be applied and improved. In spite of several positive studies, and the fact that multimodality treatment is the standard concept in major centers for pancreatic cancer surgery, a recent trial shed some doubt on the positive effect of adjuvant radiochemotherapy, so that the majority with reservations about multimodal treatment feel confirmed in their opinion that surgical treatment alone is sufficient therapy for resectable pancreatic cancer. The controversy among those for and against adjuvant treatment need an up-to-date review of the indications and results achievable with various treatment modalities. Patients/Methods: The literature on the indications and results of adjuvant/neoadjuvant therapies in pancreatic cancer was reviewed to provide a solid base for current recommendations and future developments. A special view was concentrated on the biology of the disease in the spontaneous course, after surgery and during/after various palliative and adjuvant/neoadjuvant treatment modalities, to characterize the disease for an optimally targeted treatment in conjunction with surgical removal of the tumor. The results of systemic and regional chemotherapy and radiotherapy either alone or in combination, before, during, and after surgery, were critically analyzed with respect to the oncological possibilities and pitfalls of each treatment method. Results: In two randomized trials, one testing postoperative radiochemotherapy (GITSG), and one postoperative chemotherapy (Bakkevold), the adjuvant treatment achieved a significant prolongation of the median survival time. The 5- and 10-year survival rates were improved in the GITSG study. The EORTC-GITCCG trial could not confirm the benefit of adjuvant radiochemotherapy.... (author abst.) |
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