How a significant increase in survival in pancreatic cancer is achieved. The role of nutritional status and supportive care: A review

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Abstract

Pancreatic cancer (PC) is a serious public health problem. The mortality rate of patients with PC remains one of the highest among cancers. Early diagnosis of PC is challenging, so it is often diagnosed in the later stages. Current treatment approaches, including surgery, neoadjuvant and adjuvant chemotherapy, chemoradiotherapy, and supportive care, have demonstrated improved outcomes. A significant problem remains exocrine pancreatic insufficiency (EPI) in patients with PC, which requires enzyme replacement therapy. However, this is not given due attention in the Russian literature. This review addresses the survival trends of patients with PC, current therapies, and enzyme replacement therapy as an integral part of supportive care and improvement of nutritional status; also, the issues of routing patients with PC are addressed. It is emphasized that the diagnosis and treatment of EPI are mandatory to improve and maintain the nutritional status and quality of life; failure to treat EPI renders antitumor treatment ineffective.

About the authors

Liudmila G. Zhukova

Loginov Moscow Clinical Scientific Center

Author for correspondence.
Email: l.zhukova@mknc.ru
ORCID iD: 0000-0003-4848-6938

D. Sci. (Med.), Corr. Memb. RAS

Russian Federation, Moscow

Dmitry S. Bordin

Loginov Moscow Clinical Scientific Center; Russian University of Medicine; Tver State Medical University

Email: dbordin@mail.ru
ORCID iD: 0000-0003-2815-3992

D. Sci. (Med.), Loginov Moscow Clinical Scientific Center, Russian University of Medicine, Tver State Medical University

Russian Federation, Moscow; Moscow; Tver

Elena A. Dubtsova

Loginov Moscow Clinical Scientific Center

Email: dubtsova@mail.ru
ORCID iD: 0000-0002-6556-7505

D. Sci. (Med.), Loginov Moscow Clinical Scientific Center

Russian Federation, Moscow

Matvey A. Ilin

Russian Scientific Centre of Roentgenoradiology

Email: ima22@mail.ru
ORCID iD: 0000-0002-0572-5401

Cand. Sci. (Med.)

Russian Federation, Moscow

Mariia A. Kiriukova

Loginov Moscow Clinical Scientific Center

Email: l.zhukova@mknc.ru
ORCID iD: 0000-0002-6946-3826

Res. Assist.

Russian Federation, Moscow

Polina S. Feoktistova

Loginov Moscow Clinical Scientific Center

Email: paolaf@mail.ru
ORCID iD: 0000-0002-0340-7119

Cand. Sci. (Med.), oncologist

Russian Federation, Moscow

Vyacheslav I. Egorov

Ilyinsky Hospital JSC; State Research Center – Burnasyan Federal Medical Biophysical Center

Email: v.egorov61@gmail.com
ORCID iD: 0000-0002-8805-7604

D. Sci. (Med.), Prof.

Russian Federation, Krasnogorsk; Moscow

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2. Fig. 1. Increase in five-year survival in pancreatic cancer (PC) in 1999–2023 [14, 15]

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3. Fig. 2. Algorithm for the enzyme deficiency diagnosis [45].

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