[The value of extended surgery for pancreatic cancer in the context of neoadjuvant therapy]

Zhonghua Wai Ke Za Zhi. 2020 Jul 1;58(7):481-485. doi: 10.3760/cma.j.cn112139-20200422-00323.
[Article in Chinese]

Abstract

Pancreatic cancer has a high degree of malignancy and a poor prognosis, and the treatment effect is still not ideal. For patients with advanced pancreatic cancer, extended surgery for pancreatic cancer alone cannot benefit the patients. However, with the development of neoadjuvant therapy in the field of pancreatic cancer, some cases have obtained radical operation. Studies have shown that neoadjuvant therapy, combined with extended surgery for pancreatic cancer, can improve the overall prognosis of patients, indicating that surgical techniques themselves are still useful. In this article, combined with the relevant guidelines and clinical research progress of pancreatic cancer, the controversy and progress of the extended surgery for pancreatic cancer in the context of neoadjuvant therapy is summarized, and the resectability and prognosis evaluation index after neoadjuvant therapy is discussed, in order to standardize the treatment of pancreatic cancer, enhance the understanding of extended surgery for pancreatic cancer, and further improve the prognosis of pancreatic cancer.

胰腺癌恶性程度高,预后较差,治疗效果仍不理想。对于中晚期胰腺癌患者,直接行胰腺癌扩大根治术无法使患者受益。随着新辅助治疗在胰腺癌领域的发展,部分病例在新辅助治疗后可获得手术根治机会。研究结果显示,新辅助治疗联合胰腺癌扩大切除术能够改善患者总体预后,提示手术技术本身仍具有应用价值。本文结合胰腺癌相关指南与临床研究进展,总结新辅助治疗背景下胰腺癌扩大根治术的争议与进展,并探讨新辅助治疗后胰腺癌可切除性及预后评估指标,以期促进胰腺癌规范化治疗,增强广大临床医师对胰腺癌扩大切除术的理解与认识,进一步改善胰腺癌患者的预后。.

Keywords: Extended surgery; Neoadjuvant therapy; Pancreatic neoplasms; Surgical procedures, operative.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Combined Modality Therapy
  • Humans
  • Neoadjuvant Therapy*
  • Pancreatectomy / methods*
  • Pancreatic Neoplasms / surgery*
  • Pancreatic Neoplasms / therapy
  • Prognosis