A new study describes a comprehensive treatment strategy for previously inoperable complex pancreatic adenocarcinoma that has significantly increased long-term survival for some patients.

Researchers at the University of Texas (UT) MD Anderson Cancer Center (Houston, USA) developed the new approach, which involves more accurate computerized tomography (CT) scan interpretation, chemotherapy and radiation, and a complex surgical technique that involves planned removal and reconstruction of involved vital blood vessels near the tumor. In the study, the researchers reported on 88 patients who had been told their tumors were inoperable after an initial surgical attempt at removal. Each patient’s risk for metastatic disease was stratified based on tumor involvement with local blood vessels, biopsy results and the nature of the tumor, and overall health status aside from pancreatic cancer.

Among the patients who met these criteria, 66 completed the multidisciplinary treatment regimen with successful tumor removal and the sparing of the veins and arteries in the surrounding area, an approach that has been refined at MD Anderson over the last 20 years. The results showed that on average, patients in the study lived about 30 months after tumor removal, which is almost three times longer than the 11 months for patients who are never able to have their tumors surgically removed. The study was published in the July 2012 issue of the Journal of the American College of Surgeons.

“I would say to these patients and loved ones that it is important to advocate for yourself and your family, to seek out opinions, and not necessarily go with the first thing you hear as the answer,” said lead author Jason Fleming, MD, FACS. “This study is an example of patients who have benefited by persisting. ‘Hope exists’ is the message we want these patients to hear.”

Pancreatic adenocarcinoma is one of the most devastating forms of pancreatic cancer, with survival rates of only 5% at five years. Surgical removal of these tumors offers a chance for cure, but it is estimated that only about 20% of patients can undergo this treatment, since pancreatic tumors often grow into adjacent vital blood vessels, being the most common reason a surgeon will consider pancreatic cancer inoperable and incurable. 

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