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| A new three-step procedure for pancreatic head carcinoma with invasion of superior mesenteric artery |
| Rui Tang, Jia-Hong Dong ∗ |
Department of Hepatopancreatobiliary Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No.168 Litang Road, Changping District, Beijing 102218, China
∗Corresponding author.
E-mail address: dongjiahong@mail.tsinghua.edu.cn (J.-H. Dong) |
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Abstract Pancreatic head carcinoma is characterized by high malignancy and a low survival rate and its mortality ranks fourth for malignant tumors with a 5-year survival rate of only 5% [1] . Treatment of this cancer relies on surgical resection. However, the resection rate is only about 20%, because majority of the patients are classified as unresectable when diagnosed due to distant metastasis or vascular involvement, especially the invasion of superior mesenteric artery (SMA). Local tumor recurrence often occurs in the tissues between the uncinated process and the SMA. Recently, a proportion of these unresectable patients were classified as borderline resectable according to whether the involved vessels could be excised and reconstructed when a more aggressive surgical approach was attempted. However, meta-analysis showed that pancreatectomy in combination with one-stage arterial resection results in dismal short and long-term outcomes compared to those patients without arterial resection [2] . The optimal treatment for patients with borderline resectable pancreatic carcinoma remains under investigation.
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2018, Vol. 17 
