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Background <p>Pancreatic ductal adenocarcinoma (PDAC) remains one of the most surgically and oncologically challenging malignancies. Surgical resection is the only potentially curative treatment but is available to only a&#xa0;minority of patients at initial diagnosis.</p> Objective <p>This article provides a&#xa0;structured overview of current standards and key controversies in the surgical management of pancreatic cancer.</p> Results <p>Resectability assessment integrates anatomical, biological, and clinical criteria. Neoadjuvant therapy has become established for borderline-resectable and locally advanced tumours in particular. Venous resections are now standard at specialized centres; arterial resections remain controversial. In oligometastatic PDAC, ongoing randomized trials will provide prospective evidence for the first time.</p> Conclusion <p>Key determinants of outcome are centralization in high-volume centres, integration into an interdisciplinary multimodal treatment concept, and biologically informed patient selection.</p>

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Chirurgische Therapie und Resektabilität: aktuelle Standards und Kontroversen beim Pankreaskarzinom

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月27日

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  • Artur Rebelo,
  • Carl-Stephan Leonhardt,
  • Martin Loos,
  • Jörg Kleeff

摘要

Background

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most surgically and oncologically challenging malignancies. Surgical resection is the only potentially curative treatment but is available to only a minority of patients at initial diagnosis.

Objective

This article provides a structured overview of current standards and key controversies in the surgical management of pancreatic cancer.

Results

Resectability assessment integrates anatomical, biological, and clinical criteria. Neoadjuvant therapy has become established for borderline-resectable and locally advanced tumours in particular. Venous resections are now standard at specialized centres; arterial resections remain controversial. In oligometastatic PDAC, ongoing randomized trials will provide prospective evidence for the first time.

Conclusion

Key determinants of outcome are centralization in high-volume centres, integration into an interdisciplinary multimodal treatment concept, and biologically informed patient selection.