Gebauer F, Damanakis A I, Bruns C
Klinik für Allgemein‑, Viszeral und Tumorchirurgie, Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland.
Chirurg. 2018 Jul;89(7):510-515. doi: 10.1007/s00104-018-0626-1.
Several case series reported results of surgical resection in patients with pancreatic ductal adenocarcinoma in a metastasized stage.
A summarized overview of the current state of knowledge and a summary of the results of currently available studies.
A systematic search was carried out in MEDLINE and PubMed with respect to metastasized pancreatic cancer and surgical resection.
The evidence level for surgical resection in the metastasized stage is weak and so far no prospective trials are available. The largest single-arm trial included 85 patients with hepatic metastasis. In cases of hepatic oligometastasis an overall survival of 11-14 months was observed. In the presence of pulmonary metastasis, overall survival seems to be prolonged compared to intra-abdominal metastasis, although the evidence level is relatively weak.
According to the available results, a general recommendation for surgical resection in a metastasized stage cannot be given; however, the results show a possible benefit for some well-selected patient subgroups. Prospective trials must validate these data and investigate the use of combined surgical and systemic treatments in the case of resectable metastatic pancreatic cancer.
多个病例系列报道了转移性胰腺癌患者手术切除的结果。
对当前知识状态进行综述，并总结现有研究的结果。
在MEDLINE和PubMed中对转移性胰腺癌和手术切除进行了系统检索。
转移性阶段手术切除的证据水平较弱，目前尚无前瞻性试验。最大的单臂试验纳入了85例肝转移患者。在肝寡转移病例中，观察到总生存期为11 - 14个月。在存在肺转移的情况下，与腹腔内转移相比，总生存期似乎延长，尽管证据水平相对较弱。
根据现有结果，无法对转移性阶段的手术切除给出一般性建议；然而，结果显示对一些精心挑选的患者亚组可能有益。前瞻性试验必须验证这些数据，并研究在可切除转移性胰腺癌病例中联合手术和全身治疗的应用。
