New surgical approaches to pancreatic cancer.

Surgery as the best means to careful staging is stressed, in spite of many other methods of staging. Especially in those instances where resection is remotely possible it is proposed that, if possible, surgery should be done in centers specializing in this type of operation. A final opinion on the use of extended pancreatectomy awaits additional data. It is stressed that the surgeon should be fully aware of combined modality programs for treating pancreatic cancer and that new surgical techniques be considered as their proper employment demands. Finally, possible new techniques, such as intraoperative photoradiation using a laser and hematoporphyrin, intraoperative radiation therapy and heat, and the use of microwave-induced hyperthermia are discussed. The surgeon may well find that what is new in surgical treatment of cancer of the pancreas lies in a combined modality approach, primarily using intraoperative therapy.