Abstract
The aim of the present review was to analyze the current data on surgery of synchronous liver metastases in pancreatic ductal adenocarcinoma (PDAC) in curative intent. A review of the literature was carried out to identify the current international concepts regarding surgery of liver metastases of PDAC and, furthermore, we addressed the current challenges of resection of liver metastases of PDAC. Resection of liver metastases in PDAC may provide survival benefit without compromising safety and quality of life in a highly selected group of patients.
Highlights
Pancreatic ductal adenocarcinoma (PDAC) is one of the most deadly cancers among gastrointestinal tumors
The 5‐year survival in the non‐resected group was 0% vs 5.8% in the resection group
Synchronous liver resection had higher morbidity than metachro‐ nous liver resection (33%‐45% vs 0%‐21%)
Summary
Pancreatic ductal adenocarcinoma (PDAC) is one of the most deadly cancers among gastrointestinal tumors. Because of the tumor's invasiveness and rapid development of lymph node and distant metastases, 5‐year overall survival is poor, yet in patients with resectable PDAC, negative resection margins, and no evi‐ dence of lymph node metastases, overall 5‐year survival can reach 36 months.[2]. In other types of cancer, progress in therapy and lifetime prolongation for the patient are being made, striking improvements in the therapy of pancreatic cancer are sparse.[3,4]. Most patients already harbor distant me‐ tastases resulting in only 10%‐20% of patients being in a curable stage depending on the classification of actual guidelines. The gold standard for patients in stage IV is systemic chemotherapy with FOLFIRINOX or gemcitabine with palliative intent.[5]
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