Ishido Keinosuke, Hakamada Kenichi, Kimura Norihisa, Miura Takuya, Wakiya Taiichi
Department of Gastroenterological Surgery Hirosaki University Graduate School of Medicine Hirosaki Japan.
Ann Gastroenterol Surg. 2020 Aug 9;5(1):7-23. doi: 10.1002/ags3.12379. eCollection 2021 Jan.
Pancreatic ductal adenocarcinoma (PDAC) is highly malignant. While cancers in other organs have shown clear improvements in 5-year survival, the 5-year survival rate of pancreatic cancer is approximately 10%. Early relapse and metastasis are not uncommon, making it difficult to achieve an acceptable prognosis even after complete surgical resection of the pancreas. Studies have been performed on various treatments to improve the prognosis of PDAC, and multidisciplinary approaches including non-surgical treatments have led to gradual improvement. In the present literature review, we have described the significance of anatomical and biological resectability criteria, the concept of R0 resection in surgical treatment, the feasibility of minimally invasive surgery, the remarkable development of perioperative chemotherapy, the effectiveness of conversion surgery for unresectable PDAC, and ongoing challenges in PDAC treatment. We also provide an essential update on these subjects by focusing on recent trends and topics.
胰腺导管腺癌（PDAC）具有高度恶性。虽然其他器官的癌症在5年生存率方面已显示出明显改善，但胰腺癌的5年生存率约为10%。早期复发和转移并不罕见，即使在胰腺完全手术切除后也难以获得可接受的预后。已经对各种治疗方法进行了研究以改善PDAC的预后，包括非手术治疗在内的多学科方法已带来逐步改善。在本综述中，我们描述了解剖学和生物学可切除性标准的意义、手术治疗中R0切除的概念、微创手术的可行性、围手术期化疗的显著进展、不可切除PDAC转化手术的有效性以及PDAC治疗中持续存在的挑战。我们还通过关注近期趋势和主题对这些主题进行了重要更新。
