Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.
World J Gastroenterol. 2018 Sep 7;24(33):3677-3680. doi: 10.3748/wjg.v24.i33.3677.
Pancreatic cancer remains a lethal disease and is associated with poor prognosis, particularly for patients with distant metastasis at diagnosis. Recently, Oweira reported a retrospective study that included 13233 metastatic pancreatic cancer patients from the Surveillance, Epidemiology and End Results database. They demonstrated that pancreatic cancer patients with isolated liver metastases had worse outcomes than patients with isolated lung metastases or distant nodal metastases. At present, the standard treatment for metastatic pancreatic cancer is chemotherapy. However, improvement in the safety of pancreatic surgery has led to the consideration of more aggressive surgical approaches. Schneitler reported two cases of hepatic metastatic pancreatic cancer in which negative margin (R0) resection and long survival were achieved after effective preoperative chemotherapy. In general, these two studies indicate that although pancreatic cancer patients with liver metastasis have a poor prognosis, surgical approaches may prolong survival for a few of these patients. A strategy to select hepatic metastatic pancreatic cancer patients who may benefit from surgical intervention is urgently needed.
胰腺癌仍然是一种致命的疾病，预后不良，尤其是在诊断时已经发生远处转移的患者。最近，Oweira 报道了一项回顾性研究，该研究纳入了来自监测、流行病学和最终结果数据库的 13233 例转移性胰腺癌患者。他们表明，孤立性肝转移的胰腺癌患者比孤立性肺转移或远处淋巴结转移的患者预后更差。目前，转移性胰腺癌的标准治疗方法是化疗。然而，胰腺手术安全性的提高使得人们考虑采用更激进的手术方法。Schneitler 报道了两例肝转移性胰腺癌患者，他们在有效的术前化疗后实现了阴性切缘（R0）切除和长期生存。一般来说，这两项研究表明，尽管肝转移的胰腺癌患者预后较差，但手术方法可能会延长其中一些患者的生存时间。因此，迫切需要制定一种策略来选择可能从手术干预中获益的肝转移性胰腺癌患者。
