Postresection surveillance for pancreatic cancer performance status, imaging, and serum markers Journal Article
| Authors: | O'Reilly, E. M.; Lowery, M. A. |
| Article Title: | Postresection surveillance for pancreatic cancer performance status, imaging, and serum markers |
| Abstract: | Approximately 15% of patients with a diagnosis of pancreatic adenocarcinoma are candidates for potentially curative surgery. However, most patients who undergo such surgery will die from recurrent disease, most within the first few years, whereas nearly all succumb by 5 to 7 years from diagnosis. Currently, there is a lack of high-level evidence to guide consensus recommendations as to the optimal surveillance strategy after resection. There is considerable variability in clinical practice, ranging from frequent clinical follow-up, with serial Ca 19-9 measurement and routine computed tomographic imaging on a 3-to 6-monthly basis, to a practice of no routine serum or imaging follow-up after surgery. In most part, this divergence in practice reflects a lack of data to define optimal practice. The argument in favor of limited surveillance presumably stems from the relatively uniform poor outcomes after recurrence and the absence of evidence indicating that early detection of local, regional, or metastatic recurrence improves outcomes. However, recent advancements in the treatment of metastatic disease offer hope that earlier detection and initiation of treatment for recurrent disease may positively impact clinical outcomes and at least urges review of the topic. One advantage to the development of defined guidelines would be greater consistency in the setting of both routine clinical follow-up and follow-up after adjuvant therapy on trial. Copyright © 2012 by Lippincott Williams &Wilkins. |
| Keywords: | cancer survival; protein expression; treatment outcome; cancer surgery; disease course; review; cancer recurrence; erlotinib; fluorouracil; cancer combination chemotherapy; gemcitabine; follow up; cancer diagnosis; clinical practice; computer assisted tomography; ca 19-9 antigen; practice guideline; cancer mortality; health care cost; pancreas adenocarcinoma; cancer epidemiology; pancreatic cancer; fluoropyrimidine; pancreas surgery; optimal surveillance strategy |
| Journal Title: | The Cancer Journal |
| Volume: | 18 |
| Issue: | 6 |
| ISSN: | 1528-9117 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2012-11-01 |
| Start Page: | 609 |
| End Page: | 613 |
| Language: | English |
| DOI: | 10.1097/PPO.0b013e3182758e27 |
| PROVIDER: | scopus |
| PUBMED: | 23187849 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 2 January 2013" - "CODEN: CAJOC" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work