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Cancers 2011, 3(1), 652-661; doi:10.3390/cancers3010652
Review

Palliative Interventional and Surgical Therapy for Unresectable Pancreatic Cancer

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Received: 31 December 2010; in revised form: 14 January 2011 / Accepted: 9 February 2011 / Published: 14 February 2011
(This article belongs to the Special Issue Pancreatic Cancer)
View Full-Text   |   Download PDF [111 KB, updated 15 February 2011; original version uploaded 14 February 2011]
Abstract: Palliative treatment concepts are considered in patients with non-curatively resectable and/or metastasized pancreatic cancer. However, patients without metastases, but presented with marginally resectable or locally non-resectable tumors should not be treated by a palliative therapeutic approach. These patients should be enrolled in neoadjuvant radiochemotherapy trials because a potentially curative resection can be achieved in approximately one-third of them after finishing treatment and restaging. Within the scope of best possible palliative care, resection of the primary cancer together with excision of metastases represents a therapeutic option to be contemplated in selected cases. Comprehensive palliative therapy is based on treatment of bile duct or duodenal obstruction for certain locally unresectable or metastasized advanced pancreatic cancer. However, endoscopic or percutaneous stenting procedures and surgical bypass provide safe and highly effective therapeutic alternatives. In case of operative drainage of the biliary tract (biliodigestive anastomosis), the prophylactic creation of a gastro-intestinal bypass (double bypass) is recommended. The decision to perform a surgical versus an endoscopic procedure for palliation depends to a great extent on the tumor stage and the estimated prognosis, and should be determined by an interdisciplinary team for each patient individually.
Keywords: pancreatic cancer; palliative pancreatic surgery; neoadjuvant therapy; duodenal obstruction; jaundice; prophylactic gastroenterostomy pancreatic cancer; palliative pancreatic surgery; neoadjuvant therapy; duodenal obstruction; jaundice; prophylactic gastroenterostomy
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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MDPI and ACS Style

Assfalg, V.; Hüser, N.; Michalski, C.; Gillen, S.; Kleeff, J.; Friess, H. Palliative Interventional and Surgical Therapy for Unresectable Pancreatic Cancer. Cancers 2011, 3, 652-661.

AMA Style

Assfalg V, Hüser N, Michalski C, Gillen S, Kleeff J, Friess H. Palliative Interventional and Surgical Therapy for Unresectable Pancreatic Cancer. Cancers. 2011; 3(1):652-661.

Chicago/Turabian Style

Assfalg, Volker; Hüser, Norbert; Michalski, Christoph; Gillen, Sonja; Kleeff, Jorg; Friess, Helmut. 2011. "Palliative Interventional and Surgical Therapy for Unresectable Pancreatic Cancer." Cancers 3, no. 1: 652-661.



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