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Treatment of Recurrent Pancreatic Cancer After Surgery`

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Pancreatic Cancer

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Abstract

The majority of patients with pancreatic cancer eventually develop and die from recurrence even after successful surgical resection and adjuvant therapy. Pancreatic cancer recurrence and its treatment are, therefore, very relevant clinical concerns. For several reasons there is a striking lack of knowledge and evidence with respect to the incidence and pattern, the detection, and the management of pancreatic cancer recurrence. This chapter summarizes available data on the incidence, timing, and pattern of recurrence, discusses the need for and the potential of structured surveillance programs, and provides an overview of treatment options for pancreatic cancer recurrence. While most patients will eventually die from systemic recurrences, a relevant subgroup of 20–30% of patients at first present with isolated local recurrence. For systemic recurrences chemotherapy is the only treatment option. However, data from observational cohort studies suggest that treatment strategies that include local approaches may be associated with prolonged survival patients with isolated local recurrences. In order to improve the treatment of both local and systemic recurrence of pancreatic cancer and to enable clinical trials, it will be important to establish surveillance programs after resection and to address treatment options for recurrence in future guidelines.

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Abbreviations

CA 19-9:

Carbohydrate antigen 19-9

CT:

Computed tomography

PDAC:

Pancreatic ductal adenocarcinoma

PET:

Positron emission tomography

RCT:

Randomized controlled trial

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Author information

Authors and Affiliations

  1. Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    Oliver Strobel, Willem Niesen & Markus W. Büchler

Authors
  1. Oliver Strobel
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  2. Willem Niesen
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  3. Markus W. Büchler
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Corresponding author

Correspondence to Oliver Strobel .

Editor information

Editors and Affiliations

  1. Div. Surgery & Oncology, University of Liverpool, Liverpool, United Kingdom

    John P. Neoptolemos

  2. Rochester, Minnesota, USA

    Raul Urrutia

  3. Dept. Gastrointestinal Medical Onco, Duke University Medical Center Dept. Gastrointestinal Medical Onco, Durham, North Carolina, USA

    James Abbruzzese

  4. Heidelberg, Germany

    Markus W. Büchler

Section Editor information

  1. Duke University Medical Center, Durham, NC, USA

    James L. Abbruzzese

  2. Mayo Clinic Cancer Center, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA

    Raul A. Urrutia

  3. Division of Surgery and Oncology, University of Liverpool, Daulby Street, Liverpool, UK

    John Neoptolemos

  4. Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    Markus W. Büchler MD

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Strobel, O., Niesen, W., Büchler, M.W. (2016). Treatment of Recurrent Pancreatic Cancer After Surgery`. In: Neoptolemos, J., Urrutia, R., Abbruzzese, J., Büchler, M. (eds) Pancreatic Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-6631-8_58-1

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  • DOI: https://doi.org/10.1007/978-1-4939-6631-8_58-1

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