Hepatobiliary and pancreatic (HPB) cancers are a primary cause of death worldwide, and their prevalence is increasing. Unfortunately, because of locally advanced or systemic disease, the vast majority of patients with HPB malignancies are not susceptible to up-front curative treatment at the time of diagnosis. Furthermore, even among surgically removed patients, a significant proportion will experience an early return of their cancer. As a result, novel therapeutic multimodal techniques, including neoadjuvant and per-operative therapy, are gaining widespread popularity, owing to their capacity to expand the pool of patients responsive to curative treatments while also increasing recurrence-free and overall survival. Modern multimodal strategies, such as targeted drug therapy, chemotherapy (both neoadjuvant and peri-operative), radiotherapy, surgery (preferably minimally invasive when possible), local ablative therapy, and so on, are indeed required to achieve optimal results, improve quality of life, and prolong survival.
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