The great tragedy facing the majority of patients with newly diagnosed adenocarcinoma of the pancreas is the persistent high rate of lethality:most newly diagnosed individuals will die within a year.1 Approximately 20% of patients are considered for surgical therapy; however, only about half of these individuals undergo successful resections.2- 4 Surgery remains the only opportunity for cure and can be performed with significant reduction in rates of operative morbidity and mortality, particularly at experienced high-volume centers.5 Use of neoadjuvant strategies in the preoperative setting to improve surgical resectability remain experimental. Adjuvant therapy for the postoperative pancreatic cancer patient has been a highly controversial topic with some strong differences in opinions about the use of adjuvant radiation, chemotherapy, or combined chemoradiation, particularly between investigators in the United States and Europe.6,7
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