The Re-Treatment of Recurrent Pancreatic Cancer – Revisited

We discussed two recent studies on the apparent benefits of possible re-treatment of recurrent pancreatic cancer (ductal adenocarcinoma of the pancreas) in our Pancreatica Blog entry of November 17, 2012. Now there are two more interesting medical articles on this subject that have been recently published.

Werner and colleagues from the University of Heidelberg (including Markus Buchler who is on our Science Board) in a March 1, 2013 study published in the Annals of Surgical Oncology offer that approximately 30% of pancreatic cancer recurrences are isolated and not associated with metastases. They identified almost 100 patients from 2001 until 2009 at their institution that presented with recurrence. Of the 57 with isolated local recurrence of cancer of the pancreas, 41 patients were eligible (by their criteria) for re-treatment surgery. They found that those patients who were eligible for and received such re-treatment lived significantly longer than those who were not able to receive this additional therapy.

Also, Combs and colleagues again from the University of Heidelberg (including Drs. Buchler, Werner, and two others from the above noted study) in a January 1, 2013 study published in the journal Radiation Oncology reported findings that indicated good treatment response with acceptable toxicity levels to chemoradiation (CRT) in select patients with recurrent pancreatic cancer. Additionally, in some of these patients with recurrent pancreatic cancer, the CRT allowed for additional surgical resection. These are early results and will need further substantiation by future research.

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Dale O’Brien, MD