Pancreatic Cancer pp 1169-1186 | Cite as

Modern Japanese Approach to Pancreatic Cancer

  • Takao Ohtsuka
  • Masao Tanaka
Reference work entry


Principal clues to early diagnosis of pancreatic cancer including pancreatic duct dilation, diabetes, and intraductal papillary mucinous neoplasms are discussed, referring to Japanese contributions. The Japan Pancreas Society (JPS) has revised fourth edition of Clinical Guidelines for Management of Pancreatic Cancer, providing 51 clinical questions with graded evidence-based recommendations in 2016, and diagnosis, chemotherapy, radiation therapy, surgical resection, adjuvant treatments, and supportive therapy are addressed. “Borderline resectable (BR)” pancreatic cancer is a new concept, and JPS makes two categories of BR pancreatic cancer such as involvement of only portal vein (BR-PV) and involvement of major artery (BR-A). Extended resection cannot be actively advocated in patients with pancreatic cancer in the present daily practice, because several prospective randomized trials did not confirm the survival benefit of extended resection compared to standard resection. The analysis using data of the JPS Pancreatic Cancer Registry indicates that the 5-year survival rate of patients after resection of pancreatic cancer has been significantly improved after the introduction of gemcitabine into Japan. More recently, a Japanese group has demonstrated that S-1 adjuvant chemotherapy is superior to gemcitabine. Recent great interest in Japan is to clarify the significance of neoadjuvant treatments in resectable and BR pancreatic cancer.


Pancreatic cancer Japan Pancreas Society JPS Pancreatic Cancer Registry Early diagnosis IPMN Borderline resectable Extended resection Adjuvant therapy Neoadjuvant therapy 


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Surgery and Oncology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  2. 2.Shimonoseki City HospitalShimonosekiJapan

Section editors and affiliations

  • James L. Abbruzzese
    • 1
  • Raul A. Urrutia
    • 2
  • John Neoptolemos
    • 3
  • Markus W. Büchler
    • 4
  1. 1.Duke University Medical CenterDurhamUSA
  2. 2.Mayo Clinic Cancer CenterMayo ClinicRochesterUSA
  3. 3.Division of Surgery and OncologyUniversity of LiverpoolLiverpoolUK
  4. 4.Department of General, Visceral and Transplantation SurgeryUniversity of HeidelbergHeidelbergGermany

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