Wada Keita, Takaori Kyoichi, Traverso L William
Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan.
Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-5807, Japan.
Surg Clin North Am. 2015 Oct;95(5):1041-52. doi: 10.1016/j.suc.2015.05.010. Epub 2015 Jun 23.
Neither extended surgery nor extended indication for surgery has improved survival in patients with pancreatic cancer. According to autopsy studies, presumably 90% are metastatic. The only cure is complete removal of the tumor at an early stage before it becomes a systemic disease or becomes invasive. Early detection and screening of individuals at risk is currently under way. This article reviews the evidence and methods for screening, either familial or sporadic. Indication for early-stage surgery and precursors are discussed. Surgeons should be familiar with screening because it may provide patients with a chance for cure by surgical resection.
扩大手术范围或扩大手术指征均未提高胰腺癌患者的生存率。根据尸检研究,大概90%的患者已有转移。唯一的治愈方法是在肿瘤成为全身性疾病或发生侵袭之前的早期阶段将其完全切除。目前正在对有风险的个体进行早期检测和筛查。本文回顾了家族性或散发性筛查的证据和方法。讨论了早期手术的指征和癌前病变。外科医生应熟悉筛查,因为它可能为患者提供通过手术切除治愈的机会。