Cancer of the pancreas: treatment strategy and directions for the future.

Introduction. - Pancratic carcinoma is a major public health concern, as it kills more than 6,000 people each year in France. Current knowledge and key points, - The main risk factor demonstrated by concordant case-control studies is cigarette smoking. Pancreatic carcinoma is generally diagnosed at all advanced stage. Results of radical surgery are still poor. In most of the reported ser ies, less than 25% of the patients survive at five gears. Future prospects and projects. - Postoperative radiochemotherapy slightly increases the hope of cure. In locally advanced tumors, radiochemotherapy sometimes preoperative, allows some patients to survive more than two years. Though results of palliative chemotherapy remain very poor, some clinical benefit has been observed in randomized trials comparing this treatment with the currently best supportive treatment. (C) 1999 Elsevier, Paris.