Combined treatment of pancreatic cancer - current strategies

Pancreatic cancer is one of the most common causes of cancer-related death. The prognosis, as indicated by nearly equal incidence and mortality rates, is very poor. Although the only chance for cure is currently pancreatic resection, the tumour can be removed only in about 20-30% of patients. Five-year survival rates reported in recent decades have demonstrated an increasing trend, but the 5-year survival is still only about 10-30% with the median survival of 15-20 months. A rising number of pancreatic resections along with centralisation of pancreatic cancer surgery in hospitals with adequately trained personnel resulted in reduced rates of morbidity and postoperative mortality. Previous clinical trials have emphasised the need for a combined treatment where chemotherapy or chemoradiotherapy are inseparably associated with surgical interventions. Though many enthusiastic studies have been reported, the optimal regimen of the combined therapy has not been agreed. Moreover, the differences observed between individual studies suggest that further well-designed clinical trials involving large patient populations are necessary.