Review Article Open Access Journal of Surgery [Jurnalul de Chirurgie] J o u r n a l o f S u r g e r y [ J u r n a l u l d e C h i r u r g i e ] ISSN: 1584-9341 Volume 13 • Issue 1 • 2 J Surgery, an open access journal ISSN: 1584-9341 Keywords: Pancreatic cancer; Resectability; Pancreaticoduodenectomy; Survival Introduction Pancreatic ductal adenocarcinoma is one of the most common malignant diseases of the pancreas having its origin in the ductal epithelium. It is considered a malignancy with a high degree of lethality, survival at 5 years being reported to be up to 4%. Tis poor outcome is due to both a low specifcity of onset symptoms (e.g. the disease is usually diagnosed in advanced stages) and also to a lack of tumour markers in order detects the presence of the tumour in the early stage, as well as the absence of efective non-surgical treatment modalities [1-3]. Up to now surgery is the only treatment modality that can provide a greater chance of survival, but unfortunately is an option only for about 15% of patients. In this way, early pancreatic surgical experiences were accompanied by increased morbidity and mortality [4,5]. In fact, in the in the 1960 and 1970 few pancreaticoduodenectomies were made, considering that hospital mortality was high (e.g. around 25%). However, throughout the 1980s and 1990 the experience in performing duodenopancreatectomies grew and specialized centres in pancreatic resections have emerged, with the postoperative mortality and morbidity decreasing down to 3% [6]. In this way, the surgical resections are representing to this date the only chance for curative care. Te presence of hepatic or peritoneal metastases or the appearance of a tumour invasion of the celiac trunk or superior mesenteric artery have been widely accepted as absolute contraindications for resections, but despite these selection criteria, the median survival and survival rates at 1 year have been reported to be between 15-17 months and respectively 55-68%, even afer the macroscopic curative resection [7]. In addition, a major disadvantage of this disease is the fact that the diagnosis is still late, despite the development of new technologies. In this way, the main symptoms (e.g. pain and jaundice) are occurring later on, when the tumour is already locally advanced and unresectable. Tus, for now, the only hope to establish an early diagnosis, potentially curable, is represented by a rigorous anamnesis for the early symptoms that will send the patients to the doctor in an early stage. *Corresponding author: Daniel Timofte, Senior Lecturer in General Surgery, 3rd Surgical Unit, “St Spiridon” Hospital, Bd. Independentei No 1, 700111 Iasi, Romania, Tel : +40(0)731460000; E-mail: dantimofte@yahoo.com Received November 15, 2016; Accepted December 13, 2016; Published December 20, 2016 Citation: Timofte D, Blaj M, Petrariu F, Ionescu L. Current Aspects and Survival Statistics Related to Resectability in Pancreatic Cancer. Journal of Surgery [Jurnalul de chirurgie]. 2017; 13(1): 5-9 DOI: 10.7438/1584-9341-13-1-2 Copyright: © 2017 Timofte D, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Pancreatic ductal adenocarcinoma is one of the most common malignant disease of the pancreas having its origin in the ductal epithelium. With an increasing incidence, it is considered one of the most aggressive human tumours. It has a high degree of lethality, survival at 5 years being reported to be up to 4%. This poor outcome is due to both a low specifcity of onset symptoms (e.g. the disease is usually diagnosed in advanced stages) and also to a lack of tumour markers in order detects the presence of the tumour in the early stage, as well as the absence of effective non-surgical treatment modalities. Up to now, surgery is the only treatment modality that can provide a greater chance of survival, but unfortunately is an option only for about 15% of patients. The resections for the pancreatic cancer have entered the therapeutic arsenal for almost 70 years, but despite hundreds of reports written about this topic, there is no unanimity on the effectiveness of the resection. In this way, we will describe here some current aspects and survival numbers related to resectability in the pancreatic cancer. Current Aspects and Survival Statistics Related to Resectability in Pancreatic Cancer Dan Timofte 1 *, Mihaela Blaj 2 , Florin Petrariu 3 and Lidia Ionescu 1 1 Department of Surgery, University of Medicine and Pharmacy "Gr.T. Popa" Iasi, Romania 2 Department of Anesthesiology, University of Medicine and Pharmacy "Gr.T. Popa" Iasi, Romania 3 Department of Pathology, University of Medicine and Pharmacy "Gr.T. Popa" Iasi, Romania Actuarial Versus Actual – Relevance for the Interpretation of Existing Statistical Data Te resections for the pancreatic cancer have entered the therapeutic arsenal for almost 70 years, but despite hundreds of reports written about this topic, there is no unanimity on the efectiveness of the resection. In this way, several authors have reported a survival rate of 30% or even 58% at 5 years [8,9]. Tere are even authors reporting a 100% rate [10]. On the other hand, Gudjonsson et al., states that in reality we documented only 1200 cases from roughly 200,000 patients reported since the beginning of the resections. In addition, a source of error consists in the fact that some survivors at 5 years were reported several times: same period of survival corresponding of some patients from an institution was reported up to ten times. Tus, some published articles report data collected from several institutions, each of the having already reported the data in the prior period. For example, one patient was reported in two diferent countries, 6 times in total. Moreover, the cases without resections and with survival at 5 years have been published in 18 reports from 6 diferent countries, thereby they are well documented. In this way, afer correcting the repetition, the survival group at 5 years afer resection was represented in reality by only 350 patients corresponding to a period of 65 years carrying out the pancreatic resections [11]. Te data about survival are published as actual and actuarial survival. Tus, several working groups report their experience regarding