What are the NCCN treatment guidelines for localized 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

NCCN treatment guidelines concur that resection is the only potentially curative treatment for pancreatic cancer, but note that 80% of patients present with incurably advanced disease. Key recommendations for treatment of localized disease include the following [2] :

  • Decisions about treatment and resectability should involve input from a multidisciplinary group of specialists.

  • Selection of patients for surgery should be based on the probability of cure, as determined by resection margins; other factors include comorbidities, overall performance status, and age.

  • Postoperative adjuvant therapy improves outcomes but no definite standard has been set. Options for patients who did not receive preoperative neoadjuvant therapy include clinical trials (preferred), chemotherapy, or chemoradiation. When chemotherapy alone is chosen, gemcitabine is preferred over 5-FU/leucovorin; capecitabine should only be considered when other options are contraindicated.

  • For patients who received neoadjuvant therapy, post-operative therapy options are dependant on response to neoadjuvant therapy and other clinical considerations.


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