可切除边缘性胰腺癌的管理

Management of borderline resectable pancreatic cancer.

作者信息

Lal Alysandra, Christians Kathleen, Evans Douglas B

机构信息

Department of Surgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.

出版信息

Surg Oncol Clin N Am. 2010 Apr;19(2):359-70. doi: 10.1016/j.soc.2009.11.006.

DOI:10.1016/j.soc.2009.11.006

PMID:20159519

Abstract

Borderline resectable pancreatic cancer is an emerging stage of disease defined by computed tomogrpahy criteria, patient (Katz type B), or disease characteristics (Katz type C). These patients are particularly well suited to a surgery-last strategy with induction therapy consisting of chemotherapy (gemcitabine alone or in combination) followed by chemoradiation. With appropriate selection and preoperative planning, many patients with borderline resectable disease derive clinical benefit from multimodality therapy. The use of a standardized system for the staging of localized pancreatic cancer avoids indecision and allows for the optimal treatment of all patients guided by the extent of their disease. In this article, 2 case reports are presented, and the term borderline resectable pancreatic cancer is discussed. The advantages of neoadjuvant therapy and surgery are also discussed.

摘要

可切除边缘性胰腺癌是一种由计算机断层扫描标准、患者（卡茨B型）或疾病特征（卡茨C型）定义的新兴疾病阶段。这些患者特别适合采用手术最后策略，诱导治疗包括化疗（单独使用吉西他滨或联合使用），随后进行放化疗。通过适当的选择和术前规划，许多可切除边缘性疾病患者可从多模式治疗中获得临床益处。使用标准化系统对局限性胰腺癌进行分期可避免犹豫不决，并能根据疾病范围为所有患者提供最佳治疗。本文介绍了2例病例报告，并讨论了可切除边缘性胰腺癌这一术语。还讨论了新辅助治疗和手术的优势。