Pancreatic cancer is notoriously difficult to diagnose in its early stages and has a high fatality rate.
A new study from the Mayo Clinic provides compelling evidence that a minimally invasive surgical procedure called staging laparoscopy should ideally be performed before patients begin chemotherapy.
The procedure can significantly assist in identifying cancer spread early and determining the stage of the disease, thus helping clinicians choose the most appropriate treatment plan.
Key Highlights of the Study
Published in the Journal of the American College of Surgeons, the five-year study analyzed data from over 1,000 patients newly diagnosed with pancreatic cancer.
One in five of those who underwent staging laparoscopy was found to have cancer that had spread to the liver or the peritoneal lining of the abdomen.
The procedure involves inserting a laparoscope — a device equipped with a light and camera — through small incisions in the abdomen to visually assess whether cancer has spread within the abdominal cavity.
Peritoneal washings may also be performed, where fluid is inserted and then removed from the abdominal cavity for microscopic evaluation.
Importance of Early Staging
“Staging laparoscopy may help with determining a patient’s prognosis and better inform treatment, so that patients avoid unhelpful or potentially harmful surgical therapy,” says Mark Truty, M.D., who led the study.
Due to the aggressive nature of pancreatic cancer and its poor survival rates, early identification of its spread is crucial for timely and effective treatment.
Predictive Factors for Cancer Spread
The study also identified several factors that indicate a higher likelihood of cancer spread. These include the patient’s age, the location of the tumor, and the presence of tumor markers (CA 19-9) in the blood.
According to the researchers, the more of these risk factors a patient has, the higher the probability of finding cancer spread during laparoscopy.
Recommendations and Future Applications
The study recommends that staging laparoscopy be conducted before starting chemotherapy for the majority of patients with pancreatic cancer being considered for surgery.
First author Hallbera Gudmundsdottir, M.D., notes that the results can help guide treatment options, such as whether surgical removal or chemotherapy would be the best course of action.
Conclusion
The findings of this Mayo Clinic study underline the importance of early and accurate staging in pancreatic cancer.
By employing staging laparoscopy before chemotherapy, clinicians can make more informed decisions, thus improving patient outcomes in this challenging disease.
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The study was published in the Journal of the American College of Surgeons.
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