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Neoadjuvant Therapy of Pancreatic Cancer: Definitions and Benefits

The standard treatment of resectable pancreatic cancer is surgery followed by adjuvant chemotherapy. Due to the complication rate of pancreatic surgery and the high rate of primary irresectability, neoadjuvant concepts are increasingly used for pancreatic cancer. Neoadjuvant therapy is better tolera...

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Autores principales: Heinrich, Stefan, Lang, Hauke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578014/
https://www.ncbi.nlm.nih.gov/pubmed/28933761
http://dx.doi.org/10.3390/ijms18081622
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author Heinrich, Stefan
Lang, Hauke
author_facet Heinrich, Stefan
Lang, Hauke
author_sort Heinrich, Stefan
collection PubMed
description The standard treatment of resectable pancreatic cancer is surgery followed by adjuvant chemotherapy. Due to the complication rate of pancreatic surgery and the high rate of primary irresectability, neoadjuvant concepts are increasingly used for pancreatic cancer. Neoadjuvant therapy is better tolerated than adjuvant and might decrease the surgical complication rate from pancreatic surgery. In contrast to neoadjuvant chemoradiation, the nutritional status improves during neoadjuvant chemotherapy. Also, the survival of patients who develop postoperative complications after neoadjuvant therapy is comparable to those without complications whereas the survival of patients who underwent upfront surgery and then develop surgical complications is impaired. Moreover, large data base analyses suggest a down-sizing effect and improvement of overall survival by neoadjuvant therapy. Neoadjuvant chemotherapy appears to be equally efficient in converting irresectable in resectable disease and more efficient with regard to systemic tumor progression and overall survival compared to neoadjuvant chemoradiation therapy. Despite these convincing findings from mostly small phase II trials, neoadjuvant therapy has not yet proven superiority over upfront surgery in randomized trials.
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spelling pubmed-55780142017-09-05 Neoadjuvant Therapy of Pancreatic Cancer: Definitions and Benefits Heinrich, Stefan Lang, Hauke Int J Mol Sci Review The standard treatment of resectable pancreatic cancer is surgery followed by adjuvant chemotherapy. Due to the complication rate of pancreatic surgery and the high rate of primary irresectability, neoadjuvant concepts are increasingly used for pancreatic cancer. Neoadjuvant therapy is better tolerated than adjuvant and might decrease the surgical complication rate from pancreatic surgery. In contrast to neoadjuvant chemoradiation, the nutritional status improves during neoadjuvant chemotherapy. Also, the survival of patients who develop postoperative complications after neoadjuvant therapy is comparable to those without complications whereas the survival of patients who underwent upfront surgery and then develop surgical complications is impaired. Moreover, large data base analyses suggest a down-sizing effect and improvement of overall survival by neoadjuvant therapy. Neoadjuvant chemotherapy appears to be equally efficient in converting irresectable in resectable disease and more efficient with regard to systemic tumor progression and overall survival compared to neoadjuvant chemoradiation therapy. Despite these convincing findings from mostly small phase II trials, neoadjuvant therapy has not yet proven superiority over upfront surgery in randomized trials. MDPI 2017-07-26 /pmc/articles/PMC5578014/ /pubmed/28933761 http://dx.doi.org/10.3390/ijms18081622 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Heinrich, Stefan
Lang, Hauke
Neoadjuvant Therapy of Pancreatic Cancer: Definitions and Benefits
title Neoadjuvant Therapy of Pancreatic Cancer: Definitions and Benefits
title_full Neoadjuvant Therapy of Pancreatic Cancer: Definitions and Benefits
title_fullStr Neoadjuvant Therapy of Pancreatic Cancer: Definitions and Benefits
title_full_unstemmed Neoadjuvant Therapy of Pancreatic Cancer: Definitions and Benefits
title_short Neoadjuvant Therapy of Pancreatic Cancer: Definitions and Benefits
title_sort neoadjuvant therapy of pancreatic cancer: definitions and benefits
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578014/
https://www.ncbi.nlm.nih.gov/pubmed/28933761
http://dx.doi.org/10.3390/ijms18081622
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