胰腺癌临床研究回顾与展望

Developments in clinical research on pancreatic cancer:Current and future perspectives

胰腺癌发病率呈上升趋势,临床诊治极具挑战性。近20年来,我国胰腺外科发展迅速,与国际接轨,与世界同步,学术水平和地位不断提升。胰腺癌治疗模式已从传统"surgery first"过渡至多学科综合治疗协作组(MDT);腹腔镜及机器人胰腺手术日益普及,但仍须开展随机对照试验(RCT)研究进行肿瘤学评价;手术切除范围、切缘标准日趋规范;新辅助治疗有助于改善交界可切除胰腺癌的预后。从经验性治疗到个体化施治、从极限性手术到极致性手术、从解剖学切除到生物学治愈,是胰腺癌外科治疗未来的发展方向。

The incidence of pancreatic cancer(PC)raises yearly,while the diagnosis and treatment of this disease is still extremely challenging.In the past 20 years,along with the worldwide progress in pancreatic surgery,the current academic level and status of pancreatic surgery in our country were improved rapidly.Nowadays,the treatment pattern of PC has converted from the traditional"surgery first"to multidisciplinary team.Laparoscopic and robotic pancreatic surgery becomes popular,though the RCT studies are still needed for evaluation of oncological effectiveness of minimally invasive surgery on treatment of PC.The extent of lymphadenectomy and evaluation of the resection margin status have been more and more standardized.And neoadjuvant therapy has been proved to be helpful to improve the prognosis of borderline resectable PC.For the prospects of clinical research on PC in future,the empiric therapy will be replaced by individualized treatment,the extreme surgery will be replaced by high quality surgery,and the anatomical resection for treatment of PC will be replaced by biological cure.