胰腺癌综合诊治指南（2018版）

Comprehensive guidelines for the diagnosis and treatment of pancreatic cancer （2018 version ）

胰腺癌发病率逐年增加，位列癌症致死原因第5位。尽管胰腺癌诊治现状不容乐观，但在肿瘤学新理念的推动下其临床诊疗水平近年仍取得明显进步。中国抗癌协会胰腺癌专业委员会结合现状制定了最新版《胰腺癌综合诊治指南（2018版）》，以期规范和提高中国胰腺癌诊治水平。其内容主要包括胰腺癌的诊断和分型、分期，以外科、化疗和放疗为主的综合治疗，以及患者全程管理。本指南具有鲜明的特点，除规范了诊治策略外，还以问题导向式的章节结构对胰腺癌综合诊治中的19个热点问题予以讨论和推荐，包括：对活检和标本部位进行的选择，胰腺癌临床诊断标准的制定，肿瘤可切除性的评估，术前减黄的必要性及方式，微创手术在胰腺癌中的应用，扩大切除对手术疗效的影响，标准胰头癌根治术中是否联合第16组淋巴结清扫，血清肿瘤标志物对治疗疗效的预测，以及新辅助治疗在可切除患者中的应用等。本指南的颁布将有利于专科医师对胰腺癌诊治的全面认知，能进一步规范和提高不同层次医师的诊治水平。

Pancreatic cancer ranks the fifth leading cause of cancer-related death, while the incidence has increased in the recent years.Although available diagnosis and treatment have failed to significantly improve patients′ outcome, some advances have been made along with the understanding of the new concepts from oncology over the past several years.Pancreatic Cancer Committee of Chinese Anti-Cancer Association worked out this latest edition of ＂The Clinical Practice Guidelines for Pancreatic Cancer（version 2018）＂ based on current situation to standardize and improve the diagnosis and treatment of pancreatic cancer in China.This guideline shows algorithms for the diagnosis involving classification and staging, the systematic treatment including surgical resection, systemic chemotherapy and radiation therapy, and the whole-course management model for patients with pancreatic cancer.Different from previous consensus, this guideline contains the discussions and recommendations of 19 hot-issues in the clinical practice for pancreatic cancer in a question-oriented form, such as selection of biopsy and specimen sites, clinical diagnostic criteria for pancreatic cancer, assessment of resectable pancreatic cancer, indications and methods of preoperative biliary drainage, application of laparoscopic surgery, effect of expanding resection on patients′ outcomes, dissection of group 16th lymph node in standard pancreaticoduodenectomy, prognostic value of serum tumor markers, and neoadjuvant therapy in patients with resectable pancreatic cancer, etc.This guideline aims to raise a better comprehensive understanding of the diagnosis and treatment of pancreatic cancer for specialists, and further improving and standardizing the clinical practice in different medical institutions.