Pancreatic cancer treatment: better, but a long way to go
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REVIEW ARTICLE
Pancreatic cancer treatment: better, but a long way to go Robert J. Torphy1 · Yuki Fujiwara1 · Richard D. Schulick1 Received: 25 March 2020 / Accepted: 10 April 2020 © Springer Nature Singapore Pte Ltd. 2020
Abstract Remarkable progress has been made in treating pancreatic cancer over the past century, including refinement of our surgical techniques and improvements in adjuvant and neoadjuvant therapies. Despite these advances, the incidence of pancreatic cancer is rising globally, and it remains a deadly disease. In this review, we highlight the historical perspectives of pancreatic cancer treatment and outline the areas of future advancement that will assist progression towards better outcomes. Areas of future advancement include improving prevention strategies and early detection, refining our molecular understanding of pancreatic cancer, identifying more effective systemic therapies, and improving quality of life and surgical outcomes. Furthermore, systems need to be put in place to ensure all patients with pancreatic cancer receive high quality care and are given the appropriate options and sequence of therapy. This is best achieved through multidisciplinary care. Keywords Pancreatic cancer · Pancreaticoduodenectomy · Adjuvant therapy · Neoadjuvant therapy
Introduction The Italian anatomist Giovanni Battista Morgagni was the first to describe a tumor of the pancreas, in 1761 [1]. Nearly a century later, the microscopic features of pancreatic adenocarcinoma were defined [2]. Pancreatic tumors encompass cancers that arise from the endocrine or exocrine components of the pancreas with pancreatic adenocarcinoma, arising from the exocrine pancreas, being the most common and the most aggressive. Worldwide, the incidence of pancreatic cancer is increasing and has more than doubled over the past 30 years [3]. In 2018, pancreatic cancer was the 13th most common cancer globally, with 458,918 new cases, and the 7th most common cause of cancer-related mortality, with 432,242 deaths [4]. In the United States, pancreatic cancer was estimated in 2020 to be the third leading cause of cancer-related death [5]. Since the early descriptions of pancreatic cancer, our surgical and medical treatment of this disease has evolved dramatically, making what was once uniformly a rapidly fatal malignancy, to now a more treatable disease. In this review, * Richard D. Schulick [email protected] 1
Department of Surgery, School of Medicine, Cancer Center, University of Colorado, Anschutz Medical Campus, 12631 E. 17th Avenue, C‑305, Aurora, CO 80045, USA
we highlight the historical perspectives in the treatment of pancreatic cancer, including the founders of pancreatic surgery, and the progress in adjuvant approaches towards treating pancreatic cancer. We also discuss the current progress and future goals of improving prevention and early detection, refining our molecular understanding of pancreatic cancer, identifying more effective systemic therapies, and improving quality of life and surgical outcomes
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