Das pT4-Pankreaskarzinom: Chirurgische und multimodale Behandlung

Background: Pancreatic resection and multimodal treatment are today the only potentially curative treatments for patients with T4-pancreatic cancer. Methods: Extended resections for the tumors can now be carried out with an acceptably low morbidity and mortality. The necessary extent of lymph node dissection in these locally advanced cancers is still under investigation, but local recurrence rates seem to be decreased when aggressive surgical strategies are combined with pre-, intra-, or postoperative chemoradiation. Results: The results of multimodal treatments for pancreatic cancer are presented in the current review and potentially curative and palliative treatment options discussed. Conclusions: Although the influence of a combined surgical and chemoradiation treatment seems to improve local recurrence rates and survival in patients with pancreatic cancer, the subgroup of T4-stages has not been properly evaluated. The results of ongoing prospective randomized multicenter studies will determine the importance of the different treatment modalities.