Preface| Volume 25, ISSUE 2, Pxv-xvi, April 2016

Eat When You Can, Sleep When You Can, and Don’t Mess with the Pancreas

      These three “rules” of surgical training are facetiously instilled into the psyche of all new surgical residents. The third rule was based on the limited understanding of and poor outcomes associated with the management of pancreatic diseases. Since those days, we have made substantial progress in understanding, diagnosing, and treating pancreatic diseases. This issue of Surgical Oncology Clinics of North America covers a wide range of topics that represent some of the most important advances in the field of pancreatic neoplasms, and it highlights how we continue to violate rule number three, above.
      Pancreatic neoplasms comprise both exocrine and endocrine cancers of the pancreas, as well as pancreatic cystic lesions. Highlighted in this issue are numerous advances in molecular genetics, imaging capabilities, novel therapeutics, and minimally invasive techniques that have significantly changed the practice of pancreatic neoplasms over the past decade. Advances in the molecular genetics of pancreatic cancers have identified key signaling pathways that are critical in the carcinogenesis of most, if not all, pancreatic cancers, providing an opportunity to exploit these targets on a more personalized level.
      State-of-the-art imaging capabilities and advances in the endoscopic diagnosis and treatment of both exocrine and endocrine pancreatic tumors are allowing us to better localize and determine the extent of disease prior to surgical intervention, eliminating the morbidity of many unnecessary operations. New definitions of resectable, borderline resectable, and locally advanced pancreas cancers have led to the more appropriate use of neoadjuvant therapies and selection of patients who will benefit most from surgical resection. Expertise in minimally invasive surgery is minimizing the morbidity of pancreatic surgery, and controversies in the diagnosis and management of cystic lesions of the pancreas are being better delineated.
      Articles in this issue are authored by a multidisciplinary group of several national experts across the country in the fields of molecular biology, radiology, surgery, and medical oncology who have been instrumental in the development of many of these recent advances.