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 Printable version |
Medical and surgical treatment for pancreatic adenocarcinoma |
Hépato-Gastro. Volume 18, Number 6, 622-40, Novembre-Décembre 2011, Dossier Thématique : Adénocarcinome pancréatique
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 Résumé
Texte intégral
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Author(s) : Laetitia Dahan, Mehdi Ouaissi |
Summary : About 8,000 new cases of pancreatic adenocarcinoma are diagnosed every year in France. The five-year overall survival does not exceed 5%. An efficient carcinologic surgery will not be possible for 80% of patients with pancreatic cancer. After a surgical resection with a curative intent, the five-year overall survival is about 10% but we observe a high rate of locoregional or metastatic relapses. Today, surgery alone is not sufficient because the five-year survival of patients treated with postoperative adjuvant chemotherapy is doubled in two randomized trials\; it became the reference treatment for patients with resected pancreatic adenocarcinoma, with or without lymph node involvement. Two options, 5FU-folinic acid or gemcitabine, are possible. On the contrary, chemoradiotherapy (preoperative or postoperative) does not improve survival and is not recommended. Gemcitabine was the standard for advanced patients since 1997\; however this year a triplet chemotherapy, folfirinox, showed its superiority in patients under 75 years, with good performance status and with normal bilirubin value. Targeted therapies are not recommended. New predictive factors for efficacy are under evaluation. |
Keywords : pancreatic cancer, surgery, chemotherapy, chemoradiotherapy, adjuvant treatment |
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