文章：

胰腺癌新辅助治疗的外科考量

Surgical Considerations for Neoadjuvant Therapy for Pancreatic Adenocarcinoma

原文发布日期：19 August 2023

DOI: 10.3390/cancers15164174

类型: Article

开放获取: 是

英文摘要：

Pancreatic ductal adenocarcinoma (PDAC) is a challenging disease process with a 5-year survival rate of only 11%. Neoadjuvant therapy in patients with localized pancreatic cancer has multiple theoretical benefits, including improved patient selection for surgery, early delivery of systemic therapy, and assessment of response to therapy. Herein, we review key surgical considerations when selecting patients for neoadjuvant therapy and curative-intent resection. Accurate determination of resectability at diagnosis is critical and should be based on not only anatomic criteria but also biologic and clinical criteria to determine optimal treatment sequencing. Borderline resectable or locally advanced pancreatic cancer is best treated with neoadjuvant therapy and resection, including vascular resection and reconstruction when appropriate. Lastly, providing nutritional, prehabilitation, and supportive care interventions to improve patient fitness prior to surgical intervention and adequately address the adverse effects of therapy is critical.

摘要翻译： 

胰腺导管腺癌（PDAC）是一种治疗难度较高的疾病，其五年生存率仅为11%。对于局限性胰腺癌患者，新辅助治疗具有多重理论优势，包括优化手术患者筛选、早期实施全身治疗以及评估治疗反应。本文综述了在选择患者进行新辅助治疗及根治性切除时需关注的关键手术考量因素。诊断时准确评估可切除性至关重要，这不仅应基于解剖学标准，还需结合生物学及临床标准以确定最佳治疗顺序。临界可切除或局部进展期胰腺癌最适合采用新辅助治疗联合手术切除的方案，必要时需进行血管切除与重建。最后，在手术干预前通过营养支持、预康复及支持性护理等措施提升患者体能状态，并妥善处理治疗相关不良反应，具有关键意义。

原文链接：

Surgical Considerations for Neoadjuvant Therapy for Pancreatic Adenocarcinoma