Poor: While Whipple is the best approach for a primary pancreatic or ampullary lesion, the recurrence rate at 1-2 yrs is 90%. Chemo either of the FOLFIERI or Genciabine /Abraxane combo have limited effects on liver mets which in pancreas are not considered amenable to resection. There is an FDA protocol using specific monoclonals targeting pancreas that might be available but only after chemo failure
Answered 11/23/2018
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