Systematic review of the role of surgery in the treatment of pancreatic cancer with liver oligometastases

Abstract

Pancreatic cancer remains one of the most aggressive malignancies with an extremely poor prognosis. Despite advances in systemic therapy five-year survival rates for patients with disseminated forms of the disease still do not exceed a few percent. Surgical treatment for advanced pancreatic cancer is not performed in routine practice and is considered palliative.However, efforts to introduce surgery for stage IV disease continue to be investigated particularly in patients with oligometastatic disease. This group of patients occupies an intermediate position in terms of tumor biology between localized cancer and disseminated disease, providing a theoretical rationale for the use of radical local treatment modalities in combination with effective systemic therapy.The aim of this review is to systematize current data regarding the role efficacy and safety of surgical treatment in patients with oligometastatic pancreatic cancer as well as to define the selection criteria for patients most suitable for combined treatment. This work analyzes the results of key studies and discusses prognostic factors that enable the selection of the most appropriate candidates for combined treatment.