The current situation of pancreatic cancer is that the etiology is not clear and prevention is impossible. The sensitivity and specificity of the auxiliary detection methods are low,and early diagnosis is a worldwide problem. The efficacy of existing treatment methods is not satisfactory,and it is difficult to break through in a short time. The overall 5-year survival rate is only 7. 2%. In the face of the current situation of pancreatic cancer,the solution to the key problems is to strengthen basic research,explore its etiology and pathogenesis,remove the cause,cut off the path of occurrence and development,which is the only correct way to overcome pancreatic cancer. It is an important way to significantly improve the efficacy by developing peripheral blood,urine detection technology with high sensitivity and specificity,imaging diagnosis technology,and improving the early diagnosis rate. However,the research on basic and early diagnostic techniques takes a long time and costs a lot,which makes it difficult to achieve results in a short time. Therefore,the problem to be solved urgently is to develop a personalized treatment plan through standardized MDT,optimized combination of existing diagnosis and treatment methods,so as to achieve the purpose of improving the efficacy. This expert consensus is developed from the first edition,which is based on the diagnosis and treatment status of pancreatic cancer and the dilemma that is difficult to break through in a short time,with reference to the successful diagnosis and treatment experience at home and abroad,combined with the national conditions of our country,after repeated deliberation,discussion and revison by many well-known experts in the domestic industry. This consensus discusses the meaning and purpose,the main tasks,the necessary objective conditions for carrying out,workflows,precautions,relevant clinical and basic research of MDT,multi-center MDT and eMDT mode exploration in detail. Through the formulation and publication of this consensus,we hope that it can help to promote the standardized development of pancreatic cancer MDT and improve the efficacy of pancreatic cancer in China,to summarize successful experience and promote international exchanges,to strengthen personnel training and echelon construction,to formulate relevant policies and promote the development of MDT in the whole country. This consensus is expert consensus on the MDT model developed in China,which is not only applicable to pancreatic cancer,but also can be used as a reference for other tumors.
[1] SIEGEL RL,MILLER KD,JEMAL A. Cancer Statistics,2017[J]. CA Cancer J Clin,2017,67(1):7-30.
|
[2] BRAY F,FERLAY J,SOERJOMATARAM I,et al. Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin,2018,68(6):394-424.
|
[3] ZENG H,CHEN W,ZHENG R,et al. Changing cancer survival in China during 2003-2015:A pooled analysis of 17 population-based cancer registries[J]. Lancet Glob Health,2018,6(5):e555-567.
|
[4] PATKAR V,ACOSTA D,DAVIDSON T,et al. Cancer multidisciplinary team meetings:evidence,challenges,and the role of clinical decision support technology[J]. Int J Breast Cancer,2011,2011:831605.
|
[5] Pancreatic Cancer Group,Oncology Branch. Expert consensus of the multidisciplinary comprehensive treatment collaboration group for pancreatic cancer[J]. Chin J Oncol,2013,35(5):398-400.(in Chinese)中华医学会肿瘤学分会胰腺癌学组(筹).胰腺癌多学科综合治疗协作组专家共识[J].中华肿瘤杂志,2013,35(5):398-400.
|
[6] YACHIDA S,JONES S,BOZIC I,et al. Distant metastasis occurs late during the genetic evolution of pancreatic cancer[J].Nature,2010,467(7319):1114-1117.
|
[7] DUFFY MJ,STURGEON C,LAMERZ R,et al. Tumor markers in pancreatic cancer:A European Group on Tumor Markers(EGTM)status report[J]. Ann Oncol,2010,21(3):441-447.
|
[8] FONSECA AL,FLEMING JB. Surgery for pancreatic cancer:Critical radiologic findings for clinical decision making[J]. Abdom Radiol(NY),2018,43(2):374-382.
|
[9] LINDQUIST CM,MILLER FH,HAMMOND NA,et al. Pancreatic cancer screening[J]. Abdom Radiol(NY),2018,43(2):264-272.
|
[10] WITKOWSKI ER,SMITH JK,TSENG JF. Outcomes following resection of pancreatic cancer[J]. J Surg Oncol,2013,107(1):97-103.
|
[11] KONSTANTINIDIS IT,WARSHAW AL,ALLEN JN,et al. Pancreatic ductal adenocarcinoma:Is there a survival difference for R1 resections versus locally advanced unresectable tumors? What is a“true”R0 resection?[J]. Ann Surg,2013,257(4):731-736.
|
[12] AGARWAL B,ABU-HAMDA E,MOLKE KL,et al. Endoscopic ultrasound-guided fine needle aspiration and multidetector spiral CT in the diagnosis of pancreatic cancer[J]. Am J Gastroenterol,2004,99(5):844-850.
|
[13] BUCHS NC,FROSSARD JL,ROSSET A,et al. Vascular invasion in pancreatic cancer:Evaluation of endoscopic ultrasonography,computed tomography,ultrasonography,and angiography[J].Swiss Med Wkly,2007,137(19-20):286-291.
|