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Postresection surveillance for pancreatic cancer performance status, imaging, and serum markers.
MedLine Citation:
PMID:  23187849     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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.
Authors:
Eileen M O'Reilly; Maeve A Lowery
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cancer journal (Sudbury, Mass.)     Volume:  18     ISSN:  1540-336X     ISO Abbreviation:  Cancer J     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100931981     Medline TA:  Cancer J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  609-13     Citation Subset:  IM    
Affiliation:
From the *Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY; and Weill Medical College of Cornell University, New York, NY; and †Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY.
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