Although the morbidity and mortality of pancreatic resection for cance
r has been remarkably reduced during the last 20 years, there has been
little change in long-term survival. Based on experience in the treat
ment of locally unresectable but nonmetastatic pancreatic cancer, adju
vant therapies have been devised that do have an impact on survival. T
he number of pancreatic resections remains low, however. To increase t
he number of pancreatic resections that might be performed, phase II n
eoadjuvant trials are under way in several centers. Even if successful
, they will have little effect on the proportion of patients with panc
reatic cancer who are cured. New, innovative treatments must be explor
ed.