RE: CA 19-9 in potentially resectable pancreatic cancer: Perspective to adjust surgical and preoperative therapy

摘要

I am really not a pessimist, but several concepts continue to surround the surgical management of pancreatic ade-nocarcinoma: (1) despite improvements in radiologic technology, a significant fraction of patients are still found to have unresectable disease in the operating room, (2) despite improvements in perioperative care and team-based patient management, a significant fraction of patients develop complications of surgical resection that may lead to immediate death, delayed death, or dramatically decreased quality of life, (3) the vast majority of patients will die from recurrent disease despite a acurativea resection, and (4) improvements in adjuvant therapy have lagged behind the treatment of other solid organ malignancies and offer only small improvements in median survival. If I were a pessimist, I would never operate on these patients, but instead I continue to hold out hope that each patient may be that uncommon 5- or 10-year survivor following surgical resection of pancreatic cancer.