Using Minimally Invasive Surgery to Stage Pancreatic Cancer Early Helps Determine Prognosis, Better Inform Treatment

A new study from the Mayo Clinic showed that performing minimally invasive surgery on patients with newly diagnosed pancreatic cancer using staging laparoscopy (SL) helps identify disease spread early and accurately stage the cancer, allowing for better-informed treatment planning. The results appeared in the Journal of the American College of Surgeons.

In the 5-year study, researchers retrospectively assessed data from more than 1000 patients who underwent SL from 2017 to 2021. According to the results, 1 in 5 patients who underwent SL for pancreatic cancer had disease that metastasized to either the liver or the lining of the abdomen. Moreover, the researchers observed a variety of factors that identified which patients were more likely to have advanced disease. Those factors included patient age, tumor location, and tumor markers (CA 19-9) in the blood. The researchers noted that the more risk factors identified, the higher the risk of finding metastatic pancreatic cancer.

“Based on these results, we recommend that staging laparoscopy be performed before starting chemotherapy in the majority of patients who have pancreatic cancer and are being considered for surgery,” said Hallbera Gudmundsdottir, MD, first author of the study and a general surgery resident and Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Scholar, in a press release. The findings on staging laparoscopy can help determine which treatment—such as surgical removal or chemotherapy—is the best option for each patient.

“This is an important study because it supports that staging laparoscopy may help with determining a patient’s prognosis and better inform treatment so that patients avoid unhelpful or potentially harmful surgical therapy,” said lead researcher Mark Truty, MD, a surgical oncologist at the Mayo Clinic Comprehensive Cancer Center. “Pancreatic cancer is the least survivable of all cancers, and it spreads fast. So, to have this information if cancer has spread will benefit patients and help clinicians determine the right treatment for the patient as soon as possible.”