摘要
胰腺癌恶性程度高,预后差。以外科手术为基础的综合治疗可最大程度改善胰腺癌患者的预后。但胰腺癌患者确诊时常已合并远处转移,其中以肝转移为主。大多数情况下,初诊时即转移的胰腺癌患者已失去手术机会,其标准治疗为姑息性化疗,治疗效果欠佳。近年来,随着多药联合化疗方案的实施,部分胰腺癌伴肝脏寡转移患者已通过转化手术治疗获得了生存时间的延长。然而,目前临床医师对胰腺癌伴肝脏寡转移的疾病认知仍不充分,导致其对此类患者所需的治疗方案仍不明确。笔者评述胰腺癌伴肝脏寡转移的定义,总结手术治疗的安全性和肿瘤学疗效,并从生物学可切除性角度探讨并提出具有可行性的转化手术治疗策略。
Pancreatic cancer is an aggressive malignancy with a poor prognosis.Comprehensive treatment based on surgical resection can improve prognosis of patients to a great extent.However,a significant challenge had arisen as patients were often diagnosed with distant metastases,predominantly liver metastases.Traditionally,patients presenting with metastatic pancreatic cancer have been considered unresectable,leading to palliative systemic chemotherapy as the standard treatment.With the establishment of multiagent chemotherapy protocols in recent years,the feasibility of conversion surgery in selected patients with liver oligometastasis following preoperative chemotherapy was reported.Nonetheless,the understanding of pancreatic cancer with liver oligometastases remains limited among most physicians,leaving the treatment paradigm of these patients ambiguous.In this review,the authors attempt to define liver oligometastases in pancreatic cancer,assess the safety and oncologic outcome of surgical resection,and explore feasible strategies for conversion surgery from the perspective of biological resectability.
作者
吴鹏飞
何进
Wu Pengfei;He Jin(Pancreas Center,The First Affiliated Hospital of Nanjing Medical University(Jiangsu Province Hospital),Nanjing 210029,China;Division of Hepato‐Pancreato‐Biliary Surgery,Johns Hopkins University School of Medicine,Baltimore 21287,United States)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2024年第5期667-675,共9页
Chinese Journal of Digestive Surgery
关键词
胰腺肿瘤
肝转移
寡转移疾病
生物可切除性
转化手术
预后
Pancreatic neoplasms
Liver metastases
Oligometastatic disease
Biological resectability
Conversion surgery
Prognosis
