Chirurgia (Bucur). 2022 Jun;117(4):407-414. doi: 10.21614/chirurgia.2772.
Pancreatic ductal adenocarcinoma (PDAC) is characterized by high heterogeneity; thus, even after a curative intent surgery, there is significant variability in the survival of patients, reflecting different biological behaviors. The selection of proper, personalized therapy for each patient with resectable PDAC, in multimodal therapy, by an experienced multidisciplinary team is of utmost importance to get maximal clinical benefit avoiding potentially harmful treatments. Identifications of patients with resectable PDAC that would benefit from surgical resections in the context of multimodal therapy remain a topic of interest for clinical practice. To improve PDAC patient outcomes, a significant step forward would be the integration of the molecular sub-types in the clinical decision-making between upfront surgery versus neoadjuvant treatment. Successful integration of the preoperative knowledge of the subtype of PDAC can properly guide this treatment selection to further improve patient outcomes. In this review, we present an overview of the current knowledge on the role of molecular subtyping in surgical decisions for PDAC patients.
胰腺导管腺癌 (PDAC) 的特点是高度异质性；因此，即使在进行根治性手术后，患者的生存率仍存在显著差异，反映出不同的生物学行为。在多模态治疗中，由经验丰富的多学科团队为每个可切除 PDAC 患者选择合适的个体化治疗方法至关重要，以最大限度地获得临床获益，避免潜在的有害治疗。在多模态治疗的背景下，识别哪些可切除 PDAC 患者将从手术切除中获益仍然是临床实践关注的一个话题。为了改善 PDAC 患者的预后，向前迈进的重要一步将是在手术与新辅助治疗之间的临床决策中整合分子亚型。成功整合 PDAC 分子亚型的术前知识可以正确指导这种治疗选择，以进一步改善患者的预后。在这篇综述中，我们概述了目前关于分子亚型在 PDAC 患者手术决策中的作用的知识。
