中国实用外科杂志

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可能切除的胰腺癌外科治疗争议与共识

杨尹默   

  1. 北京大学第一医院外科,北京100034
  • 出版日期:2015-01-01 发布日期:2014-12-31

  • Online:2015-01-01 Published:2014-12-31

摘要:

“可能切除(borderline resectable)”胰腺癌的临床研究为目前热点课题。由于其合并周围大血管受累,多需行联合血管切除并重建的胰腺切除术式。直接手术切除致切缘阳性的可能较大,提倡对此类病人开展新辅助治疗,以提高R0切除率。较多回顾性研究表明新辅助治疗可提高R0切除率,改善病人预后。前瞻性研究数量有限,样本量也普遍偏小,一些多中心、大样本量的前瞻性研究正在进行之中,目前尚缺乏有高级别证据的研究结果。手术、新辅助化疗、放疗在可能切除的胰腺癌中的地位和作用,尚须进一步评价。

关键词: 可能切除的胰腺癌, 新辅助治疗, 手术

Abstract:

Management strategies for borderline resectable pancreaticcancer        YANG Yin-mo.Department of Surgery,Beijing University First Hospital,Beijing 100034,China
Abstract    Borderline respectable pancreatic cancers (BRPC) are those that, although technically resectable, are at high risk for margin-positive resection following surgery de novo. Generally, such cancers are considered to be resectable with a need for vascular resection and reconstruction at pancreatectomy. In this article, The definition, pretreatment strategies, and multi-disciplinary treatment protocols for patients with BEPC are reviewed. The rationale for and results following treatment with neoadjuvant chemotherapy and chemoradiation and subsequent surgical resection of the primary tumor are described in detail and existing data are reviewed.

Key words: borderline respectable pancreatic cancers;neoadjuvant therapy, surgery