胰腺癌肝转移外科治疗策略的思考  

Consideration of surgical treatment strategies for liver metastases from pancreatic cancer

作　　者：隗瑞丽 李铎[1,3] 黄笳[1] 杨志英 Wei Ruili;Li Duo;Huang Jia;Yang Zhiying(Department of General Surgery,China-Japan Friendship Hospital,Beijing 100029,China;Capital Medical University China-Japan Friendship School of Clinical Medicine,Beijing 100029,China;Graduate School,Peking Union Medical College and Chinese Academy of Medical Sciences,Bejing 100730,China)

机构地区：[1]中日友好医院普外科肝胆胰外科,北京100029 [2]首都医科大学中日友好临床医学院,北京100029 [3]中国医学科学院北京协和医学院,北京100730

出　　处：《中华转移性肿瘤杂志》2024年第4期313-319,共7页Chinese Journal of Metastatic Cancer

基　　金：国家重点专科建设项目(2021-QTL-004)。

摘　　要：胰腺癌近年来发病率逐年增高,但长期生存率无明显改善,手术仍是目前治愈性治疗胰腺癌的有效手段。而超半数胰腺癌患者在初诊时已发生转移,肝脏是其最常见的转移部位,这类患者通常被认为无手术治疗的意义。随着更有效的系统性治疗方案的临床应用,胰腺癌的远期结果有所改善,但胰腺癌肝转移是否应进入系统性治疗联合外科手术的综合治疗模式仍有争议,且缺少循证医学证据。本文拟就近年来胰腺癌肝转移系统性治疗方案的选择、治疗后疗效的评估、手术指征及时机的确定、手术治疗初步探索的结果等方面的研究进展进行总结和分析。The incidence of pancreatic cancer has been rising recently,while the death rate has remained unchanged.The effective treatment for pancreatic cancer is surgery.However,over half of patients are initially diagnosed with metastases,and the liver is the most common metastatic site,which is usually regarded as having little relevance for surgical therapy.With the clinical application of more effective systemic therapy,the long-term outcome of pancreatic cancer has been improved.There is currently disagreement about whether pancreatic cancer with liver metastases should get systemic therapy combined with surgery,because of the absence of evidence-based medicine practice.This article reviews the recent progress in the choice of systemic treatment strategy,the evaluation of efficacy after systemic therapy,the timing of surgery,and the outcomes of initial surgical treatment exploration for liver metastatic pancreatic cancer.

关 键 词：胰腺癌 同时性肝转移 寡转移 辅助化疗 手术治疗 

分 类 号：R735.9[医药卫生—肿瘤]