Episode 167: Pancreatic Cancer Series, Pt. 2 – Resectable Disease

Episode 167: Pancreatic Cancer Series, Pt. 2 – Resectable Disease

This week our pancreatic cancer series moves from diagnosis to management, starting with resectable disease. Using the case of a 68-year-old man with a 2.8 cm adenocarcinoma of the pancreatic head, we define what "resectable" actually means, review the operation and the goal of an R0 resection, and explain why surgery alone is never enough. We then trace the adjuvant story from ESPAC-1 and CONKO-001 to today's two standards, modified FOLFIRINOX (PRODIGE 24) and gemcitabine-capecitabine (ESPAC-4), before taking on the surgery-first versus neoadjuvant debate (NORPACT-1, PREOPANC, SWOG S1505), the question of preoperative biliary stenting, and what is coming next, from perioperative trials to RAS inhibitors. As always, if you haven't heard the earlier episodes in this series, start there first.