Defining and Treating Borderline Resectable Pancreatic Cancer.

Opinion Statement: Patients with borderline resectable pancreatic ductal adenocarcinoma (BR PDAC) should receive preoperative chemotherapy with or without radiation therapy, with the intent to eradicate occult metastatic cancer cells, to select patients with a "locally dominant cancer phenotype" for...

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Publicado en:Current Treatment Options in Oncology Vol. 21; no. 9
Autores principales: Perri, Giampaolo, Prakash, Laura, Katz, Matthew H. G.
Formato: research Journal Article
Publicado: Springer Nature Sep2020
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
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        atl: Defining and Treating Borderline Resectable Pancreatic Cancer.
      aug:
        au:
          Perri, Giampaolo
          Prakash, Laura
          Katz, Matthew H. G.
        affil: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, FCT 17.6058, Unit 1484, 77030, Houston, TX, USA
      sug:
        subj:
          Pancreatic Neoplasms Therapy
          Pancreatic Neoplasms Diagnosis
          Pancreatic Neoplasms Etiology
          Pancreatic Neoplasms Mortality
          Human
          Treatment Outcomes
          Disease Susceptibility
          Preoperative Care
          Disease Management
          Prognosis
          Neoplasm Staging Methods
          Combined Modality Therapy
      ab: Opinion Statement: Patients with borderline resectable pancreatic ductal adenocarcinoma (BR PDAC) should receive preoperative chemotherapy with or without radiation therapy, with the intent to eradicate occult metastatic cancer cells, to select patients with a "locally dominant cancer phenotype" for whom local therapies might be most effective, and to reduce the anatomic extent of tumors to facilitate surgical resection. The administration of preoperative therapy may also be a useful strategy to deliver the maximum load of chemotherapy to patients with BR PDAC, since as many as half of patients will never qualify for adjuvant treatments following pancreatectomy due to postoperative morbidity or disease progression. Patients with BR PDAC should be categorized at diagnosis on the basis of anatomical, biological, and conditional criteria and should be offered induction systemic chemotherapy with close monitoring for toxicity, followed by administration of (chemo)radiation in selected cases. Patients should be restaged after systemic therapy and, if used, (chemo)radiation. Patients who continue to show disease response or disease stability without signs of progression should be considered for pancreatectomy; better measures of response to therapy are needed.
      pubtype: Academic Journal
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        Journal Article
      ougenre: Article
    language: English
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