[Causes of failure in the curative treatment of cancer of the exocrine pancreas]. / Les causes d'échec dans le traitement curatif des cancers du pancréas exocrine.

ABSTRACT

Causes of relapse are related to diagnostic delay, disagreement between early clinical diagnosis and post-surgical classification, poor performance status of patients, biological features, treatment modalities and particularly subclinical disease left after radical surgery. Gastro-intestinal specialists, radiologists, surgeons, pathologists, radiation and medical oncologists must come together to propose the best strategy exactness of pre- and post-operative staging; surgical resection performed with minimal and acceptable morbidity after due consideration of all associated risk factors; accurate pathological examination with mention of tumoral diameter, capsular invasion, multicentricity, lymph nodes and venous involvement, pTNM classification; precise systematic external beam radiotherapy, which may be enhanced by 5-FU.