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胰腺癌的多学科治疗:一例病例报告

Multidisciplinary treatment of pancreatic cancer: a case report.

作者信息

Wang Xing-Ru, Nie Lin-Xia, Guo Xiang-Hong, Liu Tian-Xi, Li Xiao-Ju, Zhang Hong-Yu, Lin Heng

机构信息

Department of Hepatobiliary Surgery, Qujing Second People's Hospital of Yunnan Province, Qujing, China.

Institute of Hepatobiliary Surgery, First Affiliated Hospital, Army Medical University, Chongqing, China.

出版信息

Gland Surg. 2022 Mar;11(3):628-636. doi: 10.21037/gs-22-86.

Abstract

BACKGROUND

Carcinoma of the head of pancreas has a high malignant degree and the 5-year survival rate at 5%. For unresectable pancreatic cancer, the 5-year survival rate is even lower. The clinical diagnosis of pancreatic cancer is difficult, and surgical indications are difficult to grasp. Moreover, perioperative and postoperative management is complex, and patients with different conditions need more attention to implement a comprehensive diagnosis and treatment strategy. In the diagnosis and treatment of pancreatic cancer and even other cancers, multi-disciplinary diagnosis and treatment can provide reasonable, personalized and more effective plans for patients so that cancer patients can receive better treatment and improve their quality of life. The multi-disciplinary diagnosis and treatment model can respond to the complex needs to individual patients.

CASE DESCRIPTION

This model is designed according to each patient's comprehensive situation, including their clinical symptoms, biochemical indicators, body mass index, and psychological status, and the tumor position, pathological tissue typing, and invasion scope. Complications of tumors can be reduced if treatment is controlled and if radical treatments are used within a broader comprehensive care model, thereby improving the quality of life of patients to prolong their survival. In our case report, the overall survival is much longer than un-resectable pancreatic cancer (median overall survival 6-9 months. The female patient was 53 years old. Her chief complaints were yellow skin, yellow urine, and absorption emaciation for 1 month. The preliminary diagnosis was postoperative pancreatic cancer. CT reexamination suggested portal vein liver metastasis. Repeated gastrointestinal bleeding occurs over the course of the disease. Postoperative review suggested recurrence, and she was admitted to First Affiliated Hospital, Army Medical University. During the treatment, the disease progressed to gastrointestinal bleeding, ascites, and jaundice.

CONCLUSIONS

After multidisciplinary treatment (MDT) discussion, targeted treatment strategies were developed to improve the symptoms and improve the quality of life of the patients.

摘要

背景

胰头癌恶性程度高,5年生存率仅5%。对于不可切除的胰腺癌,5年生存率更低。胰腺癌临床诊断困难,手术指征难以把握。此外,围手术期及术后管理复杂,不同病情患者需要更关注实施综合诊疗策略。在胰腺癌乃至其他癌症的诊治中,多学科诊疗可为患者提供合理、个性化且更有效的方案,使癌症患者获得更好治疗,提高生活质量。多学科诊疗模式能应对个体患者的复杂需求。

病例描述

该模式根据每位患者的综合情况设计,包括临床症状、生化指标、体重指数和心理状态,以及肿瘤位置、病理组织分型和侵犯范围。若在更广泛的综合护理模式下控制治疗并采用根治性治疗,可减少肿瘤并发症,从而提高患者生活质量以延长生存期。在我们的病例报告中,总生存期远长于不可切除胰腺癌(中位总生存期6 - 9个月)。该女性患者53岁,主要诉求为皮肤黄染、尿黄及消瘦1个月。初步诊断为术后胰腺癌。CT复查提示门静脉肝转移。病程中反复发生消化道出血。术后复查提示复发,遂入住陆军军医大学第一附属医院。治疗期间,病情进展为消化道出血、腹水及黄疸。

结论

经多学科治疗(MDT)讨论后,制定了针对性治疗策略,以改善症状,提高患者生活质量。

相似文献

本文引用的文献

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