Achieving 'Marginal Gains' to Optimise Outcomes in Resectable Pancreatic Cancer.
ERAS
adjuvant chemotherapy
biliary drainage
pancreatic cancer
pancreatic exocrine insufficiency
prehabilitation
Journal
Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829
Informations de publication
Date de publication:
01 Apr 2021
01 Apr 2021
Historique:
received:
04
02
2021
revised:
19
03
2021
accepted:
24
03
2021
entrez:
30
4
2021
pubmed:
1
5
2021
medline:
1
5
2021
Statut:
epublish
Résumé
Improving outcomes among patients with resectable pancreatic cancer is one of the greatest challenges of modern medicine. Major improvements in survival will result from the development of novel therapies. However, optimising existing pathways, so that patients realise benefits of already proven treatments, presents a clear opportunity to improve outcomes in the short term. This narrative review will focus on treatments and interventions where there is a clear evidence base to improve outcomes in pancreatic cancer, and where there is also evidence of variation and under-treatment. Avoidance of preoperative biliary drainage, treatment of pancreatic exocrine insufficiency, prehabiliation and enhanced recovery after surgery, reducing perioperative complications, optimising opportunities for elderly patients to receive therapy, optimising adjuvant chemotherapy and regular surveillance after surgery are some of the strategies discussed. Each treatment or pathway change represents an opportunity for marginal gain. Accumulation of marginal gains can result in considerable benefit to patients. Given that these interventions already have evidence base, they can be realised quickly and economically.
Identifiants
pubmed: 33916294
pii: cancers13071669
doi: 10.3390/cancers13071669
pmc: PMC8037133
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
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