Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Dec 15, 2015; 7(12): 375-382
Published online Dec 15, 2015. doi: 10.4251/wjgo.v7.i12.375
Multimodality treatment of recurrent pancreatic cancer: Mith or reality?
Cosimo Sperti, Lucia Moletta, Stefano Merigliano
Cosimo Sperti, Lucia Moletta, Stefano Merigliano, Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, 35128 Padua, Italy
Author contributions: Sperti C and Moletta L conceived the article and drafted the manuscript; Merigliano S made critical review; all authors read and approved the final manuscript.
Conflict-of-interest statement: None to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Cosimo Sperti, MD, Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, via Giustiniani 2, 35128 Padova, Italy. csperti@libero.it
Telephone: +39-049-8218845 Fax: +39-049-8218821
Received: May 27, 2015
Peer-review started: May 30, 2015
First decision: August 25, 2015
Revised: September 9, 2015
Accepted: October 23, 2015
Article in press: October 27, 2015
Published online: December 15, 2015
Processing time: 200 Days and 23.7 Hours
Abstract

Pancreatic adenocarcinoma is the fourth cause of cancer-related death in the United States. Surgery is the only potentially curative treatment, but most patients present at diagnosis with unresectable or metastatic disease. Moreover, even with an R0 resection, the majority of patients will die of disease recurrence. Most recurrences occur in the first 2-year after pancreatic resection, and are commonly located in the abdomen, even if distant metastases can occur. Recurrent pancreatic adenocarcinoma remains a significant therapeutic challenge, due to the limited role of surgery and radio-chemotherapy. Surgical management of recurrence is usually unreliable because tumor relapse typically presents as a technically unresectable, or as multifocal disease with an aggressive growth. Therefore, treatment of patients with recurrent pancreatic adenocarcinoma has historically been limited to palliative chemotherapy or supportive care. Only few data are available in the Literature about this issue, even if in recent years more studies have been published to determine whether treatment after recurrence have any effect on patients outcome. Recent therapeutic advances have demonstrated the potential to improve survival in selected patients who had undergone resection for pancreatic cancer. Multimodality management of recurrent pancreatic carcinoma may lead to better survival and quality of life in a small but significant percentage of patients; however, more and larger studies are needed to clarify the role of the different therapeutic options and the optimal way to combine them.

Keywords: Multimodality treatment; Pancreas; Pancreatic neoplasms; Pancreatectomy; Tumor’s recurrence

Core tip: Different therapeutic options are available for the treatment of patients with pancreatic adenocarcinoma recurrence, even if only few data have been reported in the Literature on their effective benefit for patients’ outcome. In this work we present the current English Literature about this issue, the possible indications for the different therapeutic options and the available data on patients’ outcome.