Advances and challenges in the multidisciplinary diagnosis and treatment of pancreatic cancer
-
摘要: 胰腺癌是高度恶性的消化系统肿瘤,手术切除率低,预后差。由于胰腺癌生物学行为特殊,单一手术切除已无法满足治疗的全部需要。随着癌症综合治疗理念的普及,多学科协作通过整合各科优势资源,在充分评估患者病情的基础上确定规范化、个体化的诊疗流程,把握胰腺癌患者新辅助治疗指征,并制订个体化的手术及辅助治疗方案,在胰腺癌治疗中成效显著。总结了胰腺癌多学科诊疗的进展与挑战,以期进一步提高我国胰腺癌多学科诊疗水平,改善患者预后。Abstract: Pancreatic cancer is a highly malignant tumor in the digestive system and has a low rate of surgical resection and poor prognosis.Since pancreatic cancer has unique biological behaviors, surgical resection alone cannot meet the need of clinical treatment. With the popularization of the concept of multimodality therapy, multidisciplinary collaboration can integrate the superior resources of disciplines and develop standardized and individualized diagnosis and treatment process based on patients' conditions. It can help clinicians to observe the indications for neoadjuvant therapy in patients with pancreatic cancer and develop individualized surgical and adjuvant treatment regimens and has achieved a good effect in the treatment of pancreatic cancer. This article summarizes the advances and challenges in the multidisciplinary diagnosis and treatment of pancreatic cancer, in order to improve the level of multidisciplinary diagnosis and treatment of pancreatic cancer in China and the prognosis of patients with pancreatic cancer.
-
Key words:
- pancreatic neoplasms /
- diagnosis /
- therapeutics /
- editorial
-
[1]SIEGEL RL, MILLER KD, JEMAL A.Cancer statistics, 2019[J].CA Cancer J Clin, 2019, 69 (1) :7-34. [2]CHEN W, ZHENG R, BAADE PD, et al.Cancer statistics in China, 2015[J].CA Cancer J Clin, 2016, 66 (2) :115-132. [3] KAMISAWA T, WOOD LD, ITOI T, et al.Pancreatic cancer[J].Lancet, 2016, 388 (10039) :73-85. [4] ZHAO YP.Importance of the multidisciplinary diagnosis and treatment of pancreatic cancer[J].Chin J Surg, 2016, 54 (11) :801-803. (in Chinese) 赵玉沛.重视胰腺癌的多学科诊疗[J].中华外科杂志, 2016, 54 (11) :801-803. [5]DESAI NV, SLIESORAITIS S, HUGHES SJ, et al.Multidisciplinary neoadjuvant management for potentially curable pancreatic cancer[J].Cancer Med, 2015, 4 (8) :1224-1239. [6]COVELER AL, HERMAN JM, SIMEONE DM, et al.Localized pancreatic cancer:Multidisciplinary management[J].Am Soc Clin Oncol Educ Book, 2016, 35:e217-e226. [7]RAO B, SYED A, SINGH S, et al.Performance of a multidisciplinary pancreatic cancer conference in predicting and managing resectable pancreatic cancer[J].Pancreas, 2019, 48 (1) :80-84. [8]LUO G, LIU C, GUO M, et al.CA19-9-Low&Lewis (+) pancreatic cancer:A unique subtype[J].Cancer Lett, 2017, 385:e217-e226.. [9]PORUK KE, GAY DZ, BROWN K, et al.The clinical utility of CA19-9 in pancreatic adenocarcinoma:Diagnostic and prognostic updates[J].Curr Mol Med, 2013, 13 (3) :340-351. [10] MELO SA, LUECKE LB, KAHLERT C, et al.Glypican-1 identifies cancer exosomes and detects early pancreatic cancer[J].Nature, 2015, 523 (7559) :177-182. [11]Society of Pancreatic Cancer, Chinese Anti-cancer Association.Comprehensive guidelines for the diagnosis and treatment of pancreatic cancer (2018 version) [J].J Clin Hepatol, 2018, 34 (10) :2109-2120. (in Chinese) 中国抗癌协会胰腺癌专业委员会.胰腺癌综合诊治指南 (2018版) [J].临床肝胆病杂志, 2018, 34 (10) :2109-2120. [12]RENI M, BALZANO G, ZANON S, et al.Safety and efficacy of preoperative or postoperative chemotherapy for resectable pancreatic adenocarcinoma (PACT-15) :A randomised, open-label, phase 2-3 trial[J].Lancet Gastroenterol Hepatol, 2018, 3 (6) :413-423. [13]TORPHY RJ, FRIEDMAN C, HALPERN A, et al.Comparing short-term and oncologic outcomes of minimally invasive versus open pancreaticoduodenectomy across low and high volume centers[J].Ann Surg, 2018.[Epub ahead of print] [14]van HILST J, de ROOIJ T, BOSSCHA K, et al.Laparoscopic versus open pancreatoduodenectomy for pancreatic or periampullary tumours (LEOPARD-2) :A multicentre, patientblinded, randomised controlled phase 2/3 trial[J].Lancet Gastroenterolo Hepatol, 2019, 4 (3) :199-207. [15]WANG M, PENG B, LIU J, et al.Practice patterns and perioperative outcomes of laparoscopic pancreaticoduodenectomy in China:A retrospective multicenter analysis of 1029 patients[J].Ann Surg, 2019.[Epub ahead of print]
本文二维码
计量
- 文章访问数: 1752
- HTML全文浏览量: 56
- PDF下载量: 440
- 被引次数: 0