General Surgery, Division of Surgical Oncology, University of Cincinnati Cancer Institute, University of Cincinnati Medical Center, 231 Albert Sabin Way, ML 0558, Cincinnati, OH 45267, USA.
Division of Surgical Oncology, University of Cincinnati Cancer Institute, University of Cincinnati Medical Center, 231 Albert Sabin Way, ML 0558, Cincinnati, OH 45267, USA.
Surg Clin North Am. 2024 Oct;104(5):987-1005. doi: 10.1016/j.suc.2024.04.002. Epub 2024 May 16.
While pancreatic adenocarcinoma requires surgical resection definitive cure, treatment paradigms are shifting toward a neoadjuvant approach to systemic therapy. Rationale is twofold: micro-metastatic disease is likely present in a majority of patients, reinforcing the importance of systemic therapy regardless of resectability; moreover, systemic therapy is well-tolerated and improves surgical outcomes when delivered preoperatively. Second, a neoadjuvant approach allows for selection of biology and patients most likely to benefit from potentially morbid surgery. This review examines the increasing body of evidence in support of empiric neoadjuvant therapy in pancreatic adenocarcinoma.
虽然胰腺腺癌需要通过手术切除来实现明确的治愈，但治疗模式正在向新辅助系统治疗方法转变。这有两个原因：大多数患者可能存在微转移疾病，这强化了无论可切除性如何都需要进行系统治疗的重要性；此外，术前给予系统治疗耐受性良好，并可改善手术结果。其次，新辅助方法允许选择最有可能从潜在高风险手术中获益的生物学特性和患者。本文综述了越来越多的证据支持在胰腺腺癌中采用经验性新辅助治疗。
