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Commentary on: Divestment or skeletonization of the SMA or the hepatic artery for locally advanced pancreatic ductal cancer after neoadjuvant therapy

Published:December 02, 2020DOI:https://doi.org/10.1016/j.surg.2020.10.042
      Pancreatic ductal adenocarcinoma remains one of the most lethal human tumors, and it is expected to become the second leading cause of cancer-related death in the United States by 2030.
      • Rahib L.
      • Smith B.D.
      • Aizenberg R.
      • Rosenzweig A.B.
      • Fleshman J.M.
      • Matrisian L.M.
      Projecting cancer incidence and deaths to 2030: The unexpected burden of thyroid, liver, and pancreas cancers in the United States.
      Despite this negative trend, in the last decade, remarkable improvement in the progmosis for patients with pancreas cancer has been observed, mostly related to new and more effective systemic chemotherapies.
      • Conroy T.
      • Hammel P.
      • Hebbar M.
      • et al.
      FOLFIRINOX or gemcitabine as adjuvant therapy for pancreatic cancer.
      With the achievement of more effective systemic control of the disease, many of the paradigms related to the treatment of pancreas cancer are changing. The traditional “anatomic” criteria of resectability should most likely be replaced by new and more prognosis-based criteria that makes effective use of the “biology” of a particular patient’s pancreatic cancer.
      • Oba A.
      • Croce C.
      • Hosokawa P.
      • et al.
      Prognosis based definition of resectability in pancreatic cancer: A road map to new guidelines.
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