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Volume 8
Issue 11
10.3390/jcm8111922
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Review

Are We Sure that Adjuvant Chemotherapy is the Best Approach for Resectable Pancreatic Cancer? Are We in the Era of Neoadjuvant Treatment? A Review of Current Literature

by
Ester Oneda
and
Alberto Zaniboni
*
Department of Clinical Oncology, Fondazione Poliambulanza, 25124 Brescia, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(11), 1922; https://doi.org/10.3390/jcm8111922
Received: 17 September 2019 / Revised: 6 November 2019 / Accepted: 7 November 2019 / Published: 8 November 2019
(This article belongs to the Special Issue Current Standards and New Innovative Approaches for Treatment of Pancreatic Cancer)
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Abstract

The outcome of pancreatic cancer is poor, with a 9% 5-year survival rate. Current treatment recommendations in the 10%–20% of patients who present with resectable disease support upfront resection followed by adjuvant therapy. Until now, only early complete surgical (R0) resection and adjuvant chemotherapy (AC) with either FOLFIRINOX (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) or nab-paclitaxel plus gemcitabine have been shown to prolong the survival. However, up to 30% of patients do not receive adjuvant therapy because of the development of early recurrence, postoperative complications, comorbidities, and reduced performance status. The aims of neoadjuvant chemotherapy (NAC) are to identify rapidly progressing patients to avoid futile surgery, eliminate micrometastases, increase the feasibility of R0 resection, and ensure the completion of multimodal treatment. Neoadjuvant treatments are effective, but there is no consensus on their use in resectable pancreatic cancer (RPC) because of its lack of a survival benefit over adjuvant therapy. In this review, we analyze the advantages and disadvantages of the two therapeutic approaches in RPC. We need studies that compare the two approaches and can identify the appropriate sequence of adjuvant therapy after neoadjuvant treatment and surgery. View Full-Text
Keywords: pancreatic cancer; adjuvant chemotherapy; neoadjuvant chemotherapy pancreatic cancer; adjuvant chemotherapy; neoadjuvant chemotherapy
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

Oneda, E.; Zaniboni, A. Are We Sure that Adjuvant Chemotherapy is the Best Approach for Resectable Pancreatic Cancer? Are We in the Era of Neoadjuvant Treatment? A Review of Current Literature. J. Clin. Med. 2019, 8, 1922. https://doi.org/10.3390/jcm8111922

AMA Style

Oneda E, Zaniboni A. Are We Sure that Adjuvant Chemotherapy is the Best Approach for Resectable Pancreatic Cancer? Are We in the Era of Neoadjuvant Treatment? A Review of Current Literature. Journal of Clinical Medicine. 2019; 8(11):1922. https://doi.org/10.3390/jcm8111922

Chicago/Turabian Style

Oneda, Ester, and Alberto Zaniboni. 2019. "Are We Sure that Adjuvant Chemotherapy is the Best Approach for Resectable Pancreatic Cancer? Are We in the Era of Neoadjuvant Treatment? A Review of Current Literature" Journal of Clinical Medicine 8, no. 11: 1922. https://doi.org/10.3390/jcm8111922

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