What are the ASCO guidelines for postoperative treatment of pancreatic cancer?

Updated: Mar 07, 2019
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

Postoperative recommendations include the following [92] :

  • In the absence of medical or surgical contraindications, patients who did not receive preoperative therapy should be offered 6 months of adjuvant chemotherapy with either gemcitabine or fluorouracil plus folinic acid initiated within 8 weeks of surgical resection.
  • Patients who have not received preoperative therapy and who have microscopically positive margins or node-positive disease after 4 to 6 months of adjuvant chemotherapy should be offered adjuvant chemoradiation.
  • For patients who underwent peroperative therapy, although evidence supporting the duration of post-operative therapy is weak, the panel recommends that patients receive a total of 6 months of adjuvant therapy, including time spent on the preoperative regimen.
  • Adjuvant combination chemotherapy regimens are not recommended outside of a clinical trial. 
  • Patients  should receive ongoing supportive care for symptom burden that may result from the operation and (preoperative and/or adjuvant) chemotherapy
  • Patients who have completed treatment and have no evidence of disease should be monitored for recovery of treatment-related toxicities and recurrence. Visits may be offered at 3- to 6-month intervals but the role of serial cross-sectional imaging, the extent to which surveillance intervals should be prolonged over time, and the duration of recommended surveillance are all undefined

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