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Últimos avances en tumores de páncreas
Authors:Julio Iglesias-García  J Enrique Domínguez-Muñoz
Institution:Servicio de Aparato Digestivo, Fundación para la Investigación en Enfermedades del Aparato Digestivo (FIENAD), Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, España
Abstract:Pancreatic cancer is difficult to diagnose and treat. Prognosis is poor, since this disease is usually detected at advanced stages, when the possibilities of any treatment with curative intent are 20% or less. To improve prognosis, new screening strategies are being designed, especially with the development of a new international consensus with recommendations on the management of patients at high risk of developing pancreatic cancer.Two especially useful techniques in the diagnosis of this disease are elastography and contrast-enhanced endoscopic ultrasound (EUS). Advances have been made in EUS-guided biopsy with the development of histology needles that increase diagnostic efficacy and the quality of the samples. Finally, there have been a few advances in treatment. The role of neoadjuvant therapy in locally advanced tumors and the efficacy of distinct neurolysis strategies in pain therapy have been confirmed. Covered metallic stents seem to be the best option to treat biliary obstruction. A notable development is the development of EUS-guided confocal endomicroscopy to improve the diagnosis and follow-up of cystic tumors of the pancreas, especially intraductal papillary mucinous tumors of the lateral branch.
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