Point de vue sur les traitements adjuvant et néoadjuvant du cancer du pancréas en 2010.

out 7200 pancreatic adenocarcinomas are diagnosed every year in France. In 80% of cases, a complete surgical resection of the tumor, which is the only treatment to provide a long-term survival to the patients, is not feasible due to locoregional or metastatic spread of the disease. After a surgical resection with a curative intent, the median overall survival does not exceed 12 to 20 months due to the tumor relapse. Hence, therapeutic trials have been developed using chemotherapy or chemo/radiotherapy as adjuvant/neoadjuvant treatments combined with surgery in order to achieve better long-term survival. It is now admitted that adjuvant chemotherapy may delay tumor relapse and even increase survival in a subset of patients (10%). This has yet not been demonstrated using chemoradiotherapy. Neoadjuvant treatment with chemo/radiotherapy, especially in patients with bordeline tumour, could increase the rate of resectability in a small number of patients, margin-free surgical resections, and local control of the tumor. These approaches need to be validated prospectively. Finally, in a small number of patients with locally advanced tumors being in good condition, the treatment with chemo/radiotherapy may allow to propose a secondary resection. [ABSTRACT FROM AUTHOR]