Patients with pancreatic cancer formally believed to not be eligible for surgery may in fact benefit from resection, according to findings from two recent studies.
Pancreatic cancer can be an especially difficult disease to treat due to the fact that it has often spread throughout the body by the time patients present with symptoms, ruling out surgery. However, results of a study presented at the Pancreas Club and Society for Surgery of the Alimentary Tract annual meetings in San Diego, CA may have found that surgery is still an option for certain patients whose cancer has not spread throughout the body, but has grown around the veins and arteries in and around the pancreas.
Oncologists from the Mayo Clinic reviewed 25 years of data on patients with stage III pancreatic cancer who required the removal and reconstruction of arteries. They found that most of the surgeries were performed within the last 5 years, with the advent of improved chemotherapy and radiation treatments.
While surgery is has a greater risk than other treatment methods, the use of chemotherapy and radiation followed by aggressive operations was associated with significantly improved overall survival. Improvement in the long-term was not as pronounced in patients who underwent surgery without radiation or chemotherapy, and complication rates decreased over time in the short-term.
"All in all, [this study] shows that these patients, who would typically not be offered an operation, can have good short-term and long-term results with the appropriate protocol and treatment sequence," said Mark Truty, MD, a gastrointestinal surgical oncologist at the Mayo Clinic in Rochester, MN.
In a follow-up presentation at the Pancreas Club meeting, researchers presented more recent data on 80 patients with pancreatic cancer who have gone through a Mayo Clinic protocol of chemotherapy, radiation, and aggressive surgery. In these patients, the median survival time after patients completed the protocol was four yeas, significantly higher than what is observed in patients who do not have surgery.
Doctors involved in the study hope that the results will be disseminated to the field a provide an example for how to improve outcomes of patients with pancreatic cancer. However, Dr Truty, did note that physician still need to consider the desires of patients while informing them of all possible treatment avenues.