Currently, the surgical management of pancreas cancer is recognized around the
world as inadequate. Long-term survival is rare even though there is a potentially curative
R0 resection. There is a strong rationale for the use of chemotherapy in the operating room
to reduce local-regional and hepatic sites of recurrent/progressive disease. Gemcitabine
monotherapy administered by an intraperitoneal route in the operating room with
hyperthermia and then for long-term treatment postoperatively has a strong pharmacologic
basis. The exposure of peritoneal surfaces to intraperitoneal gemcitabine is approximately
500 times the exposure that occurs within the plasma. By analogy to another lethal disease,
ovarian cancer, intraperitoneal gemcitabine chemotherapy using following potentially
curative resection is supported. A standardized treatment with intraoperative chemotherapy
monitoring of gemcitabine would greatly facilitate further improvements in pancreas
cancer treatment and lead the way to an evolution of more successful treatment strategies of
this dread disease. The aim of this chapter is to present the recent available medical
information and patents applicable to patients with resected pancreatic cancer.
Keywords: Cancer pharmacology, chemoradiation therapy, chemotherapy,
gemcitabine, gemcitabine monotherapy, hepatic metastases, hyperthermia,
intraperitoneal chemotherapy, intraperitoneal port, local recurrence, local-regional
recurrent disease, long-term intraperitoneal chemotherapy, pancreas cancer,
pharmacokinetics, randomized trials.
