Afonso Ribeiro, MD, medical director of Advanced Endoscopy and Gastroenterology at Memorial Healthcare System, discusses the role of surgery in treating patients with pancreatic cancer.

Due to its status as a systemic disease, surgery has a limited role in treating pancreatic cancer, explains Ribeiro. Surgery has been used to treat pancreatic cancer for decades, according to Ribeiro, but it has yet to change the survival outcomes of the disease. Ribeiro suggests performing the surgery with laparoscopy to make it quicker and more precise to get rid of residual disease.

Pancreatic cancer often stays on nerve cells, which is a sanctuary for pancreatic cancer. Agents that can target the residual disease in nerve cells, which cannot be seen on imaging tests, are necessary, as well as better systemic chemotherapy, concludes Ribeiro.

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Afonso Ribeiro, MD, discusses the role of surgery in treating patients with pancreatic cancer.

Dr. Ribeiro on the Role of Surgery in Pancreatic Cancer

Afonso Ribeiro, MD, medical director of Advanced Endoscopy and Gastroenterology at Memorial Healthcare System, discusses the criteria that can be used to determine whether a patient with pancreatic cancer has borderline resectable disease.

The definition of “borderline resectable” is somewhat subjective, says Ribeiro, as it varies from institution to institution. However, collaborative efforts between surgeons and medical oncologists, as well as consensus guidelines, are helping to standardize the criteria for borderline resectable disease.

Patients with borderline resectable disease typically have a lot of tumor contact with the vein or some contact with the artery, which prevents surgeons from seeing a clear tissue plane on those blood vessels, explains Ribeiro. Generally, the majority of patients with borderline resectable disease will not have an R0 resection if they’re taken to surgery. Those patients will have a higher risk of residual disease after surgery. Therefore, instead of taking patients to surgery and running the risk of heavy residual disease, patients with borderline resectable disease are given neoadjuvant therapy, concludes Ribeiro.

Afonso Ribeiro, MD, medical director of Advanced Endoscopy and Gastroenterology at Memorial Healthcare System, discusses the criteria that can be used to determine whether a patient with pancreatic cancer is borderline resectable.

Afonso Ribeiro, MD

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Dr. Ribeiro on the Role of Surgery in Pancreatic Cancer

Dr. Ribeiro on Criteria for Determining Borderline Resectability in Pancreatic Cancer