What are the ESMO treatment guidelines for resectable 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

ESMO recommendations for treatment of resectable disease are as follows [63] :

  • Pancreatoduodenectomy (Whipple procedure) is the treatment of choice for tumors of the pancreatic head

  • For tumors in the body or tail of the pancreas, distal pancreatectomy, including the resection of the body and the tail of the pancreas and the spleen, is usually performed

  • No evidence exists that extended lymphadenectomy is beneficial; standard lymphadenectomy should involve the removal of ≥15 lymph nodes to allow adequate pathologic staging

  • Postoperative gemcitabine or 5-fluorouracil (5-FU) chemotherapy is recommended

  • No chemoradiation should be given to patients after surgery except in clinical trials

For patients with borderline resectable lesions, ESMO recommends participation in clinical trials wherever possible. Otherwise, preoperativechemotherapy (gemcitabine or FOLFIRINOX) followed by chemoradiation and then surgery appears to be the best option.


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