ABSTRACT
Despite impressive advances in basic molecular biology and the continued evolution of high-resolution imaging techniques for the pancreas, the inescapable fact remains that the most common type of pancreatic cancer-ductal adenocarcinoma-continues to be a highly lethal disease with few long-term survivors. This dismal prognosis is due in large part to the lack of serum markers to detect subclinical disease, and the paucity of early symptoms prior to the development of metastases. Although surgical resection with tumor-free margins does confer a modest degree of survival benefit, actual survival following “curative resection” is only in the order of 11% to 25% after five years (1-4). Overall, fewer than 4% of patients with pancreatic carcinoma survive five years (5-7). Throughout the industrialized world, pancreatic surgery is now largely performed at specialized centers by experienced pancreatic surgeons. This has contributed to a significant reduction in the morbidity and mortality from pancreaticoduodenectomy; however, it has not resulted in a substantial improvement in the long-term survival. Thus, surgery cannot truly be considered curative for pancreatic cancer.
