Surgical management of pancreatic cancer: The Mayo Clinic approach

David R. Farley, Michael B. Farnell, John H. Donohue, Geoffrey B. Thompson, Jon A. Van Heerden, Clive S. Grant, Michael G. Sarr

Research output: Contribution to journalArticle

Abstract

Between 1981 and 1991, we performed 174 'curative' resections for histopathologically confirmed, and histologically reconfirmed, ductal cancer of the pancreas during a time period when we evaluated 2,558 patients with pancreatic cancer (27). Approximately 16% of these resections proved to have positive margins, either grossly or microscopically, usually in the uncinate region. Overall 5-year actuarial survival was 6.8%; excluding the 28 patients with positive margins increased the survival to 12%. This experience further demonstrates that although surgeons debate about different types of resection and adjuvant care, at presentation the vast majority of patients ultimately prove to have incurable disease despite having either resectable or unresectable tumors. Greater emphasis thus should concentrate on earlier diagnosis, neoadjuvant treatment protocols, and adjuvant systemic therapy to salvage patients with occult distant metastases. It is hoped that advances in imaging, serologic markers, and aggressive screening of patients at increased risk (i.e., chronic pancreatitis, familial pancreatitis, or familial pancreatic cancer) using molecular diagnostic techniques (such as k-ras or P53) will lead to the improvement in patient outcome.

Original languageEnglish (US)
Pages (from-to)109-116
Number of pages8
JournalProblems in General Surgery
Volume14
Issue number2
StatePublished - Jun 1997

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Pancreatic Neoplasms
Molecular Diagnostic Techniques
Salvage Therapy
Neoadjuvant Therapy
Survival
Chronic Pancreatitis
Clinical Protocols
Early Diagnosis
Neoplasm Metastasis
Neoplasms

ASJC Scopus subject areas

  • Surgery

Cite this

Farley, D. R., Farnell, M. B., Donohue, J. H., Thompson, G. B., Van Heerden, J. A., Grant, C. S., & Sarr, M. G. (1997). Surgical management of pancreatic cancer: The Mayo Clinic approach. Problems in General Surgery, 14(2), 109-116.

Surgical management of pancreatic cancer : The Mayo Clinic approach. / Farley, David R.; Farnell, Michael B.; Donohue, John H.; Thompson, Geoffrey B.; Van Heerden, Jon A.; Grant, Clive S.; Sarr, Michael G.

In: Problems in General Surgery, Vol. 14, No. 2, 06.1997, p. 109-116.

Research output: Contribution to journalArticle

Farley, DR, Farnell, MB, Donohue, JH, Thompson, GB, Van Heerden, JA, Grant, CS & Sarr, MG 1997, 'Surgical management of pancreatic cancer: The Mayo Clinic approach', Problems in General Surgery, vol. 14, no. 2, pp. 109-116.
Farley DR, Farnell MB, Donohue JH, Thompson GB, Van Heerden JA, Grant CS et al. Surgical management of pancreatic cancer: The Mayo Clinic approach. Problems in General Surgery. 1997 Jun;14(2):109-116.
Farley, David R. ; Farnell, Michael B. ; Donohue, John H. ; Thompson, Geoffrey B. ; Van Heerden, Jon A. ; Grant, Clive S. ; Sarr, Michael G. / Surgical management of pancreatic cancer : The Mayo Clinic approach. In: Problems in General Surgery. 1997 ; Vol. 14, No. 2. pp. 109-116.
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