current state of surgical management of pancreatic cancer当前状态的胰腺癌的手术治疗.pdf

Cancers 2011, 3, 1253-1273; doi:10.3390/cancers3011253 OPEN ACCESS cancers ISSN 2072-6694 /journal/cancers Review Current State of Surgical Management of Pancreatic Cancer Thilo Hackert *, Markus W. Büchler and Jens Werner Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; E-Mails: markus_buechler@med.uni-heidelberg.de (M.W.B.); jens_werner@med.uni -heidelberg.de (J.W.) * Author to whom correspondence should be addressed; E-Mail: thilo_hackert@med.uni-heidelberg.de; Tel.: +49 6221 566110; Fax +49 6221 565450. Received: 10 February 2011; in revised form: 19 February 2011 / Accepted: 10 March 2011/ Published: 10 March 2011 Abstract: Pancreatic cancer is still associated with a poor prognosis and remains—as the fourth leading cause of cancer related mortality—a therapeutic challenge. Overall long-term survival is about 1–5%, and in only 10–20% of pancreatic cancer patients is potentially curative surgery possible, increasing five-year survival rates to approximately 20–25%. Pancreatic surgery is a technically challenging procedure and has significantly changed during the past decades with regard to technical aspects as well as perioperative care. Standardized resections can be carried out with low morbidity and mortality below 5% in high volume institutions. Furthermore, there is growing evidence that also more extended resections including