Influence of molecular pathology on oncological surgery of pancreatic cancer

Pancreatic cancer is a very aggressive malignant disease with an extremely poor prognosis; however, the survival of patients at all tumor stages is highly variable. Standard therapies, which are based predominantly on the TNM classification, patient's general condition and comorbidities, are highly variable in their effectiveness. In recent years, new technologies with multi-omics tumor characterizations have revealed the molecular heterogeneity of pancreatic cancer; however, in routine clinical practice, pancreatic cancer is usually considered as a uniform disease without paying attention to the individual tumor biology. Recent clinical studies have shown that molecular analyses can identify pharmacological targets and prognosis-relevant or treatment-relevant subtypes. Better methods for prognosis prediction and stratification based on clinical and molecular parameters could help to create more effective personalized multimodal therapy concepts and replace uniform standard therapies.