Dr. Choti Discusses Role of Surgery in Pancreatic Cancer

Michael A. Choti, MD, chief of surgery, Banner MD Anderson Cancer Center, discusses the role of surgery in the treatment of patients with pancreatic cancer.

Pancreatic adenocarcinoma remains a very aggressive and life-threatening disease. The only curative strategy for these patients is surgery, but Choti says that the vast majority of these patients do not have operable disease at the time of presentation. Most patients with pancreatic cancer have either metastatic or locally advanced disease, which precludes the ability to resect the tumor. As a result, early diagnosis through imaging is crucial.

If there is no evidence of metastatic disease and the tumor is located away from vital veins and arteries, surgery can be a potential treatment option. The surgical approach is chosen based on where the tumor is located in the pancreas—head, body, or tail, Choti notes. For example, if the tumor is in the head of the pancreas, a Whipple procedure referred to as a pancreaticoduodenectomy is often used, whereas if the tumor is located in the body or tail of the pancreas, then a distal pancreatectomy can be done.

In recent years, a multimodality approach has emerged in the treatment of patients with pancreatic cancer. There are now more effective forms of systemic chemotherapy available, says Choti, and these agents are being introduced not only in the advanced setting, but more aggressively in upfront treatment.