Multidisciplinary consensus statement on the clinical management of patients with pancreatic cancer
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SPECIAL ARTICLE
Multidisciplinary consensus statement on the clinical management of patients with pancreatic cancer E. Martin‑Perez1 · J. E. Domínguez‑Muñoz2 · F. Botella‑Romero3 · L. Cerezo4 · F. Matute Teresa5 · T. Serrano6,7 · R. Vera8 Received: 5 December 2019 / Accepted: 1 April 2020 © The Author(s) 2020
Abstract Pancreatic cancer (PC) remains one of the most aggressive tumors with an increasing incidence rate and reduced survival. Although surgical resection is the only potentially curative treatment for PC, only 15–20% of patients are resectable at diagnosis. To select the most appropriate treatment and thus improve outcomes, the diagnostic and therapeutic strategy for each patient with PC should be discussed within a multidisciplinary expert team. Clinical decision-making should be evidencebased, considering the staging of the tumor, the performance status and preferences of the patient. The aim of this guideline is to provide practical and evidence-based recommendations for the management of PC. Keywords Pancreatic cancer · Diagnosis · Surgery · Chemotherapy · Radiotherapy · Guidelines
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12094-020-02350-6) contains supplementary material, which is available to authorized users. * E. Martin‑Perez [email protected] 1
Department of Surgery, Hospital Universitario de La Princesa, Diego de Leon 62, 28006 Madrid, Spain
2
Department of Gastroenterology and Hepatology, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
3
Department of Endocrinology, Hospital General Universitario, Albacete, Spain
4
Department of Radiation Oncology, Hospital Universitario de La Princesa, Madrid, Spain
5
Department of Radiology, Hospital Clínico San Carlos, Madrid, Spain
6
Department of Pathology, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
7
Oncology Program, CIBEREHD National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, Madrid, Spain
8
Department of Medical Oncology, Complejo Hospitalario de Navarra, Pamplona, Spain
Pancreatic cancer (PC) represents the fourth leading cause of cancer-related death, and it has been estimated to become the second by 2030 [1, 2]. PC is divided into four general categories: resectable, borderline resectable, locally advanced/ unresectable, and metastatic. Surgical resection remains the primary curative treatment for patients with PC, although only 15–20% will present with initially resectable disease. Approximately 30–40% of patients show locally advanced PC, and another 40% have distant metastatic disease [3–5]. Over the past decades, there has been considerable improvement in imaging and surgical techniques, and more effective chemotherapy and radiotherapy techniques have been developed [6, 7]. Decisions about the appropriate diagnostic and therapeutic strategy for each patient with PC should involve a multidisciplinary team
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