Allgemein- und Viszeralchirurgie up2date, Table of Contents Allgemein- und Viszeralchirurgie up2date 2021; 15(06): 493-510DOI: 10.1055/a-1626-6097 Leber, Galle, Pankreas, Milz Entwicklung der Chirurgie im Wandel der multimodalen Therapien beim Pankreaskarzinom Georg Wiltberger , Ulf Peter Neumann Recommend Article Abstract Buy Article All articles of this category Die vorliegende Arbeit soll einen weiterführenden Überblick über die Entwicklung der Chirurgie beim Pankreaskarzinom im Rahmen aktueller multimodaler Behandlungsstrategien bieten. Diese Weiterentwicklung ist eng verknüpft mit der Etablierung neuer multimodaler Therapiealgorithmen, auf welche hier verstärkt eingegangen werden soll. Der Artikel versteht sich dabei als Ergänzung bzw. Weiterführung der Übersichtsarbeit aus dem Heft Allgemein- und Viszeralchirurgie up2date 06/2019 [1]. Schlüsselwörter SchlüsselwörterOnkologie - Bauchspeicheldrüsenkrebs - Malignom - Tumorerkrankung - Tumorchirurgie - Chemotherapie Full Text References Literatur 1 Belyaev O, Uhl W. Pankreaskarzinom – Chirurgie im Wandel der multimodalen Therapiemöglichkeiten. Allg Viszeralchir up2date 2019; 13 (06) 511-530 2 Coffman A, Torgeson A, Lloyd S. Correlates of refusal of surgery in the treatment of non-metastatic pancreatic adenocarcinoma. Ann Surg Oncol 2019; 26: 98-108 3 Neoptolemos JP, Dunn JA, Stocken DD. et al. Adjuvant chemoradiotherapy and chemotherapy in resectable pancreatic cancer: a randomised controlled trial. Lancet 2001; 358: 1576-1585 4 Oettle H, Neuhaus P, Hochhaus A. et al. Adjuvant chemotherapy with gemcitabine and long-term outcomes among patients with resected pancreatic cancer: the CONKO-001 randomized trial. JAMA 2013; 310: 1473-1481 5 Conroy T, Hammel P, Hebbar M. et al. FOLFIRINOX or Gemcitabine as adjuvant therapy for pancreatic cancer. N Engl J Med 2018; 379: 2395-2406 6 Tempero MA, Reni M, Riess H. et al. APACT: phase III, multicenter, international, open-label, randomized trial of adjuvant nab-paclitaxel plus gemcitabine (nab-P/G) vs. gemcitabine (G) for surgically resected pancreatic adenocarcinoma. J Clin Oncol 2019; 37: 4000 7 Tempero M, O’Reilly E, Van Cutsem E. et al. Phase 3 APACT trial of adjuvant nab-paclitaxel plus gemcitabine vs gemcitabine alone in patients with resected pancreatic cancer: Updated 5-year overall survival. 2021 ESMO World Congress on Gastrointestinal Cancer. Abstract LBA-1. Presented June 30, 2021 8 Katz MHG, Shi Q, Meyers JP. et al. Alliance A021501: Preoperative mFOLFIRINOX or mFOLFIRINOX plus hypofractionated radiation therapy (RT) for borderline resectable (BR) adenocarcinoma of the pancreas. J Clin Oncol 2021; 39: 377 9 Hackert T, Sachsenmaier M, Hinz U. et al. Locally advanced pancreatic cancer: neoadjuvant therapy with folfirinox results in resectability in 60 % of the patients. Ann Surg 2016; 264: 457-463 10 Isaji S, Mizuno S, Windsor JA. et al. International consensus on definition and criteria of borderline resectable pancreatic ductal adenocarcinoma 2017. Pancreatology 2018; 18: 2-11 11 Belyaev O, Uhl W. Pankreaskarzinom – Pathologie, Ätiologie und diagnostisches Vorgehen. Allg Viszeralchir up2date 2019; 13 (06) 495-508 12 Persigehl T, Baumhauer M, Baessler B. et al. Structured reporting of solid and cystic pancreatic lesions in CT and MRI: consensus-based structured report templates of the German Society of Radiology (DRG). Rofo 2020; 192: 641-656 13 Tas F, Sen F, Odabas H. et al. Performance status of patients is the major prognostic factor at all stages of pancreatic cancer. Int J Clin Oncol 2013; 18: 839-846 14 Reames BN, Blair AB, Krell RW. et al. Management of locally advanced pancreatic cancer: results of an international survey of current practice. Ann Surg 2021; 273: 1173-1181 15 [Anonymous] National Comprehensive Cancer Network. Pancreatic adenocarcinoma. National Comprehensive Cancer Network; 2021 16 Ghaneh P, Palmer DH, Cicconi S. et al. ESPAC-5F: Four-arm, prospective, multicenter, international randomized phase II trial of immediate surgery compared with neoadjuvant gemcitabine plus capecitabine (GEMCAP) or FOLFIRINOX or chemoradiotherapy (CRT) in patients with borderline resectable pancreatic cancer. J Clin Oncol 2020; 38: 4505 17 Kunzmann V, Siveke JT, Algül H. et al. Nab-paclitaxel plus gemcitabine versus nab-paclitaxel plus gemcitabine followed by FOLFIRINOX induction chemotherapy in locally advanced pancreatic cancer (NEOLAP-AIO-PAK-0113): a multicentre, randomised, phase 2 trial. Lancet Gastroenterol Hepatol 2021; 6: 128-138 18 Truty MJ, Kendrick ML, Nagorney DM. et al. Factors predicting response, perioperative outcomes, and survival following total neoadjuvant therapy for borderline/locally advanced pancreatic cancer. Ann Surg 2021; 273: 341-349 19 Uhl W, Ettrich TJ, Reinacher-Schick AC. et al. NEONAX trial: Neoadjuvant plus adjuvant or only adjuvant nab-paclitaxel plus gemcitabine for resectable pancreatic cancer, a phase II study of the AIO pancreatic cancer group (AIO-PAK-0313) – Safety interim analysis. J Clin Oncol 2019; 37: 4128 20 Ahmad SA, Duong M, Sohal DPS. et al. Surgical Outcome Results From SWOG S1505: A Randomized Clinical Trial of mFOLFIRINOX Versus Gemcitabine/Nab-paclitaxel for Perioperative Treatment of Resectable Pancreatic Ductal Adenocarcinoma. Ann Surg 2020; 272: 481-486 21 Neoptolemos JP, Moore MJ, Cox TF. et al. Effect of adjuvant chemotherapy with fluorouracil plus folinic acid or gemcitabine vs. observation on survival in patients with resected periampullary adenocarcinoma: the ESPAC-3 periampullary cancer randomized trial. JAMA 2012; 308: 147-156 22 Neoptolemos JP, Palmer DH, Ghaneh P. et al. Comparison of adjuvant gemcitabine and capecitabine with gemcitabine monotherapy in patients with resected pancreatic cancer (ESPAC-4): a multicentre, open-label, randomised, phase 3 trial. Lancet 2017; 389: 1011-1024 23 Uhl W, Oldhafer K, Schnitzbauer AA. et al. Stellungnahme der Chirurgischen Arbeitsgemeinschaft Leber, Galle, Pankreas (CALGP) der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV) zum Rapid Report V19-03: Zusammenhang Leistungsmenge und Qualität bei komplexen Eingriffen am Pankreas. Chirurg 2021; 92: 444-447 24 Fortner JG. Regional resection and pancreatic carcinoma. Surgery 1973; 73: 799-800 25 Mollberg N, Rahbari NN, Koch M. et al. Arterial resection during pancreatectomy for pancreatic cancer: a systematic review and meta-analysis. Ann Surg 2011; 254: 882-893 26 Bachellier P, Addeo P, Faitot F. et al. Pancreatectomy with arterial resection for pancreatic adenocarcinoma: how can it be done safely and with which outcomes? A Single institutionʼs experience with 118 patients. Ann Surg 2020; 271: 932-940 27 Loos M, Kester T, Klaiber U. et al. Arterial resection in pancreatic cancer surgery: effective after a learning curve. Ann Surg 2020; 28 Cai B, Lu Z, Neoptolemos JP. et al. Sub-adventitial divestment technique for resecting artery-involved pancreatic cancer: a retrospective cohort study. Langenbecks Arch Surg 2021; 406: 691-701 29 Appleby LH. The coeliac axis in the expansion of the operation for gastric carcinoma. Cancer 1953; 6: 704-707 30 Mayumi T, Nimura Y, Kamiya J. et al. Distal pancreatectomy with en bloc resection of the celiac artery for carcinoma of the body and tail of the pancreas. Int J Pancreatol 1997; 22: 15-21 31 Klompmaker S, Peters NA, van Hilst J. et al. Outcomes and Risk score for distal pancreatectomy with celiac axis resection (DP-CAR): An international multicenter analysis. Ann Surg Oncol 2019; 26: 772-781 32 Truty MJ, Colglazier JJ, Mendes BC. et al. En bloc celiac axis resection for pancreatic cancer: classification of anatomical variants based on tumor extent. J Am Coll Surg 2020; 231: 8-29