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Pancreas cancer (PDAC) is a highly lethal
human cancer, with a 7% 5 year overall survival rate. Because of the difficulty
of early diagnosis and unsatisfactory of the therapeutic efficacy, this lethal
disease has always been an active research topic in oncological surgery. Recently,
liquid biopsy has been nominated to diagnose for early stage of PDAC. The most
common analytical targets are circulating tumor cells (CTCs) and DNAs (ctDNA)
using blood or pancreas juice samples. Although this non-invasive technique is
still experimental, liquid biopsy should be expected for the early diagnosis of
PDAC, especially in high risk patients such as chronic pancreatitis or IPMN
near future. A recent advantage of PDAC treatment is the nomination of an
effective chemotherapeutic regimen such as FOLFIRINOX or nab-PTX+GEM. These
regimens significantly improved the median survival of advanced PDAC patients
with distant metastasis. Now trend of surgical option is the combination with
chemotherapy. Neo-adjuvant chemotherapy might be superior, compare to adjuvant
chemotherapy by recent reports. Conversion surgery in patients with advanced
PDAC after chemotherapy should be one of the attractive options for not only
borderline resectable cases but unresectable cases. Other targeting treatments
including nano-liposomal chemotherapeutic agent and inhibition of immune check
point are wildly examined. Lower invasive surgery such as laparoscopic surgery
and robotics might be considering for early treatment of chemotherapies.
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