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| Surgical exploration with non-resection in the setting of resectable, borderline and locally advanced pancreatic cancer |
| Kjetil Soreide a , b |
a Department of Gastrointestinal Surgery, HPB Unit, Stavanger University Hospital, P.O. Box 8100, Stavanger N-4068, Norway
b Department of Clinical Medicine, University of Bergen, Bergen, Norway
E-mail address: ksoreide@mac.com |
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Abstract Pancreatic cancer has an overall dismal prognosis compared to most other malignancies. In general, only about 15%-20% of patients are deemed upfront resectable at time of diagnosis, with a similar proportion presenting with either borderline or locally advanced disease [1]. Novel and more effective treatment regimens including FOLFIRINOX have made yet more patients become resectable, with up to 60% reported in some centers [2]. Technical advances in surgery continue to literally explore new anatomical territory [3]. More aggressive attitude towards resection of involved vessels has provided opportunity for curative attempt resections, even for a subpopulation of biological responders staged with pre-treatment unresectable disease [4,5]. However, while surgery is the dominant modality for a potential curative approach to pancreatic cancer, there is a subgroup of patients scheduled for surgery who ends up with an aborted resection during explorative laparotomy, also referred to as an “openclose laparotomy”. The reasons for such non-resection events are manyfold and have likely changed over time. Indeed, in one Italian study the non-resection rate remained constant at about 25% over two decades [6] . While many institutional series report nonresection rates in the same range, these figures may be influenced by patient selection, referral patterns and institutional policies towards resection and surgical aggressiveness [2,4,6].
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2022, Vol. 21 
