Huguier M, Mason N P
Departement de Chirurgie Digestive, Hôpital Universitaire Tenon, Paris, France.
Am J Surg. 1999 Mar;177(3):257-65. doi: 10.1016/s0002-9610(99)00003-3.
The incidence of cancer of the exocrine pancreas varies among populations, being the fourth or fifth cause of cancer death in the West. Outcome remains poor and opinions remain divided over the optimal management of the condition.
A computer literature search was made of the MEDLINE database from January 1990 to December 1997 and selected other studies.
Indications and contraindications for surgery, indications for stenting, indications for resection, the technique of palliative procedures and of resection, chemotherapy, radiotherapy, and combined treatments and other treatments are discussed and recommendations made.
Irrespective of tumor size or spread, resection if feasible gives the best survival rates. Careful patient selection is required, however, to exclude those patients for whom surgical resection has no benefit. Nonsurgical procedures including endoscopic stenting in patients with high operative risk or short survival expectancy can significantly improve quality of life. The place of adjuvant therapies remains controversial and further controlled trials are required to demonstrate their efficacy.
外分泌性胰腺癌的发病率在不同人群中有所差异，在西方是癌症死亡的第四或第五大原因。其预后仍然很差，对于该病的最佳治疗方法，观点仍存在分歧。
对1990年1月至1997年12月的MEDLINE数据库进行计算机文献检索，并选择其他研究。
讨论了手术的适应证和禁忌证、支架置入的适应证、切除的适应证、姑息性手术和切除技术、化疗、放疗、联合治疗及其他治疗方法，并给出了建议。
无论肿瘤大小或扩散情况如何，若可行，手术切除能提供最佳生存率。然而，需要仔细选择患者，以排除那些手术切除无益处的患者。对于手术风险高或预期生存期短的患者，包括内镜支架置入在内的非手术治疗可显著改善生活质量。辅助治疗的作用仍存在争议，需要进一步的对照试验来证明其疗效。
