Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania.
Department of Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius University Hospital Santaros klinikos, 08410 Vilnius, Lithuania.
Medicina (Kaunas). 2022 Jun 1;58(6):756. doi: 10.3390/medicina58060756.
Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal tumors, with a 5-year overall survival rate of less than 10%. To date, curative surgical resection remains the only favorable option for improving patients' survival. However, there is no consensus on which prognostic biochemical, radiological markers or neoadjuvant therapy regimens would benefit patients the most. A literature review was performed focusing on overall survival, R0 resection, 30-day mortality, adverse events (AEs), and elevated biomarkers. The electronic databases were searched from 2015 to 2020. We reviewed 22 independent studies. In total, 20 studies were retrospective single- or multi-center reviews, while 2 studies were prospective Phase II trials. Patients with borderline resectable or locally advanced PDAC, who received neoadjuvant therapy (NAT) and surgery, have significantly better survival rates. The CA 19-9 biomarker levels in the neoadjuvant setting should be evaluated and considered as a specific biomarker for tumor resectability and overall survival.
胰腺导管腺癌（PDAC）仍然是最致命的肿瘤之一，5 年总生存率低于 10%。迄今为止，治愈性手术切除仍然是改善患者生存的唯一有利选择。然而，对于哪些预后生化、影像学标志物或新辅助治疗方案最能使患者受益，目前尚无共识。我们进行了一项文献综述，重点关注总生存率、R0 切除率、30 天死亡率、不良事件（AEs）和升高的生物标志物。从 2015 年到 2020 年，电子数据库进行了搜索。我们回顾了 22 项独立的研究。总的来说，有 20 项研究是回顾性的单中心或多中心回顾性研究，而有 2 项研究是前瞻性的 II 期试验。接受新辅助治疗（NAT）和手术的边界可切除或局部晚期 PDAC 患者的生存率显著提高。新辅助治疗环境中的 CA 19-9 生物标志物水平应进行评估，并被视为肿瘤可切除性和总生存率的特定生物标志物。
