The realities of oncological surveillance after surgery for pancreatic adenocarcinoma in Poland and worldwide - a narrative review.

<b>Introduction:</b> Pancreatic ductal adenocarcinoma (PDAC) is one of the most common causes of cancer mortality worldwide, and most patients develop local and/or distant recurrence at some point during follow-up. <br><br><b>Aim:</b> This review aims to present the follow-up protocols used in Poland and worldwide for patients undergoing surgical treatment for PDAC. <br><br><b>Material and methods:</b> The analysis included studies on oncological follow-up following surgical treatment for pancreatic adenocarcinoma. After searching PubMed, Scopus, and Google Scholar databases using the terms "pancreatic adenocarcinoma recurrence", "surveillance after pancreatic adenocarcinoma resection", "postopererative follow-up for pancreatic adenocarcinoma", 50 articles were ultimately qualified for analysis. <br><br><b>Results:</b> Currently, there are no unified international standards for postoperative follow-up for PDAC. Furthermore, standardized national guidelines do not exist in Poland; thus, the optimal modality and duration of surveillance remain undefined. Furthermore, the impact of early detection and treatment of recurrence on survival and quality of life is unknown. Early detection of recurrence potentially offers greater treatment options due to systematic improvements in the treatment of local recurrence and distant metastases (DM), but it may also be associated with increased economic burden on "the payer" (healthcare system), without clearly translating into benefits resulting from longer survival. Currently, there are no clear recommendations on this issue - it seems necessary to conduct prospective studies to assess whether increased postoperative surveillance can translate into improved survival of patients with PDAC. <br><br><b>Conclusions:</b> Multidisciplinary collaboration in developing uniform, nationwide oncological surveillance principles can enable effective supervision of patients with PDAC and bring health benefits. <br><br><b>The importance of this work for the development of the field:</b> This summary of the applicable guidelines and the proposed corrective actions proposed by the authors can translate into progress and improved treatment outcomes in this challenging therapeutic area.