Recent Developments in the Treatment of Pancreatic Cancer

Detalhes bibliográficos
Autor(a) principal: Paulino, Jorge
Data de Publicação: 2023
Outros Autores: Mansinho, Hélder
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19957
Resumo: Pancreatic duct adenocarcinoma is currently the sixth-leading cause of cancer death worldwide and the fourth in Europe, with a continuous increase in annual lethality in Portugal during the last two decades. Surgical en-bloc resection of the tumor with microscopic-negative margins and an adequate lymphadenectomy is the only possibility of long-term survival. As this type of cancer is a systemic disease, there is a high rate of recurrence even after curative resection, turning systemic therapy the core of its management, mostly based on chemotherapy. Neoadjuvant strategies for nonmetastatic disease showed significant improvement in overall survival compared with upfront surgery, namely in borderline resectable disease. Moreover, these strategies provided downstaging in several situations allowing R0 resections. Under these new oncologic strategies, several recent surgical issues were introduced, namely more aggressive vascular resections and even tumor resections in oligometastatic disease. This review revisits the state-of-the-art of surgical and oncological interventions in pancreatic duct adenocarcinoma and highlights recent advances in the field aiming to achieve higher survival rates.
id RCAP_00ec676d18d0e7aa26916b94d8b36929
oai_identifier_str oai:ojs.www.actamedicaportuguesa.com:article/19957
network_acronym_str RCAP
network_name_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository_id_str 7160
spelling Recent Developments in the Treatment of Pancreatic CancerDesenvolvimentos Recentes no Tratamento do Cancro do PâncreasCarcinoma, Pancreatic Ductal/drug therapyCarcinoma, Pancreatic Ductal/surgeryCarcinoma, Pancreatic Ductal/therapyPancreatic Neoplasms/drug therapyPancreatic Neoplasms/surgeryPancreatic Neoplasms/therapyCarcinoma Ductal Pancreático/cirurgiaCarcinoma Ductal Pancreático /tratamentoCarcinoma Ductal Pancreático/tratamento farmacológicoNeoplasias Pancreáticas/cirurgiaNeoplasias Pancreáticas/tratamentoNeoplasias Pancreáticas/tratamento farmacológicoPancreatic duct adenocarcinoma is currently the sixth-leading cause of cancer death worldwide and the fourth in Europe, with a continuous increase in annual lethality in Portugal during the last two decades. Surgical en-bloc resection of the tumor with microscopic-negative margins and an adequate lymphadenectomy is the only possibility of long-term survival. As this type of cancer is a systemic disease, there is a high rate of recurrence even after curative resection, turning systemic therapy the core of its management, mostly based on chemotherapy. Neoadjuvant strategies for nonmetastatic disease showed significant improvement in overall survival compared with upfront surgery, namely in borderline resectable disease. Moreover, these strategies provided downstaging in several situations allowing R0 resections. Under these new oncologic strategies, several recent surgical issues were introduced, namely more aggressive vascular resections and even tumor resections in oligometastatic disease. This review revisits the state-of-the-art of surgical and oncological interventions in pancreatic duct adenocarcinoma and highlights recent advances in the field aiming to achieve higher survival rates.O adenocarcinoma ductal é atualmente a sexta causa de morte oncológica a nível mundial, e a quarta na Europa, com um aumento contínuo da letalidade anual em Portugal nas duas últimas décadas. A ressecção cirúrgica em bloco do tumor com margens microscopicamente negativas e com uma linfadenectomia adequada é a única possibilidade de sobrevida a longo prazo. Como o adenocarcinoma ductal é uma doença sistémica tem uma alta taxa de recidiva, mesmo depois de uma ressecção curativa, tornando a terapêutica sistémica o centro da sua abordagem, baseada sobretudo em quimioterapia. As estratégias neoadjuvantes para a doença não metastizada demonstraram uma melhoria significativa na sobrevida global em comparação com a cirurgia direta, nomeadamente em doença tangencialmente ressecável. Além disso, estas estratégias possibilitaram um re-estadiamento inferior em várias situações, permitindo ressecções R0. Sob essas novas estratégias oncológicas, foram introduzidas várias modalidades cirúrgicas recentes, nomeadamente ressecções vasculares mais agressivas e mesmo ressecções tumorais na doença oligometastática. Esta revisão aborda o estado da arte das intervenções cirúrgicas e oncológicas no adenocarcinoma ductal pancreático e destaca os avanços recentes na área visando alcançar maiores taxas de sobrevida.Ordem dos Médicos2023-10-02info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19957Acta Médica Portuguesa; Vol. 36 No. 10 (2023): October; 670-678Acta Médica Portuguesa; Vol. 36 N.º 10 (2023): Outubro; 670-6781646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19957https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19957/15234Direitos de Autor (c) 2023 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessPaulino, JorgeMansinho, Hélder2023-10-08T03:00:16Zoai:ojs.www.actamedicaportuguesa.com:article/19957Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:33:57.420548Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Recent Developments in the Treatment of Pancreatic Cancer
Desenvolvimentos Recentes no Tratamento do Cancro do Pâncreas
title Recent Developments in the Treatment of Pancreatic Cancer
spellingShingle Recent Developments in the Treatment of Pancreatic Cancer
Paulino, Jorge
Carcinoma, Pancreatic Ductal/drug therapy
Carcinoma, Pancreatic Ductal/surgery
Carcinoma, Pancreatic Ductal/therapy
Pancreatic Neoplasms/drug therapy
Pancreatic Neoplasms/surgery
Pancreatic Neoplasms/therapy
Carcinoma Ductal Pancreático/cirurgia
Carcinoma Ductal Pancreático /tratamento
Carcinoma Ductal Pancreático/tratamento farmacológico
Neoplasias Pancreáticas/cirurgia
Neoplasias Pancreáticas/tratamento
Neoplasias Pancreáticas/tratamento farmacológico
title_short Recent Developments in the Treatment of Pancreatic Cancer
title_full Recent Developments in the Treatment of Pancreatic Cancer
title_fullStr Recent Developments in the Treatment of Pancreatic Cancer
title_full_unstemmed Recent Developments in the Treatment of Pancreatic Cancer
title_sort Recent Developments in the Treatment of Pancreatic Cancer
author Paulino, Jorge
author_facet Paulino, Jorge
Mansinho, Hélder
author_role author
author2 Mansinho, Hélder
author2_role author
dc.contributor.author.fl_str_mv Paulino, Jorge
Mansinho, Hélder
dc.subject.por.fl_str_mv Carcinoma, Pancreatic Ductal/drug therapy
Carcinoma, Pancreatic Ductal/surgery
Carcinoma, Pancreatic Ductal/therapy
Pancreatic Neoplasms/drug therapy
Pancreatic Neoplasms/surgery
Pancreatic Neoplasms/therapy
Carcinoma Ductal Pancreático/cirurgia
Carcinoma Ductal Pancreático /tratamento
Carcinoma Ductal Pancreático/tratamento farmacológico
Neoplasias Pancreáticas/cirurgia
Neoplasias Pancreáticas/tratamento
Neoplasias Pancreáticas/tratamento farmacológico
topic Carcinoma, Pancreatic Ductal/drug therapy
Carcinoma, Pancreatic Ductal/surgery
Carcinoma, Pancreatic Ductal/therapy
Pancreatic Neoplasms/drug therapy
Pancreatic Neoplasms/surgery
Pancreatic Neoplasms/therapy
Carcinoma Ductal Pancreático/cirurgia
Carcinoma Ductal Pancreático /tratamento
Carcinoma Ductal Pancreático/tratamento farmacológico
Neoplasias Pancreáticas/cirurgia
Neoplasias Pancreáticas/tratamento
Neoplasias Pancreáticas/tratamento farmacológico
description Pancreatic duct adenocarcinoma is currently the sixth-leading cause of cancer death worldwide and the fourth in Europe, with a continuous increase in annual lethality in Portugal during the last two decades. Surgical en-bloc resection of the tumor with microscopic-negative margins and an adequate lymphadenectomy is the only possibility of long-term survival. As this type of cancer is a systemic disease, there is a high rate of recurrence even after curative resection, turning systemic therapy the core of its management, mostly based on chemotherapy. Neoadjuvant strategies for nonmetastatic disease showed significant improvement in overall survival compared with upfront surgery, namely in borderline resectable disease. Moreover, these strategies provided downstaging in several situations allowing R0 resections. Under these new oncologic strategies, several recent surgical issues were introduced, namely more aggressive vascular resections and even tumor resections in oligometastatic disease. This review revisits the state-of-the-art of surgical and oncological interventions in pancreatic duct adenocarcinoma and highlights recent advances in the field aiming to achieve higher survival rates.
publishDate 2023
dc.date.none.fl_str_mv 2023-10-02
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19957
url https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19957
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19957
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19957/15234
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2023 Acta Médica Portuguesa
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Direitos de Autor (c) 2023 Acta Médica Portuguesa
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 36 No. 10 (2023): October; 670-678
Acta Médica Portuguesa; Vol. 36 N.º 10 (2023): Outubro; 670-678
1646-0758
0870-399X
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
_version_ 1817550263392665600

Registros relacionados