胰腺癌合并肝脏寡转移:联合切除还是姑息治疗

Surgical resection or palliative care for pancreatic cancer with liver oligometastasis

胰腺癌作为预后最差的消化道肿瘤,50%病人确诊时已合并远处转移,其中以肝脏转移最常见。胰腺癌合并远处转移一直被认为是手术禁忌证,但在多学科综合治疗协作组模式下,特别是近年来随着化疗、靶向药物的研发及治疗方案的新型组合,越来越多的证据表明:对于部分经化疗筛选的肝脏寡转移病人,外科治疗可显著改善预后。笔者回顾近年胰腺癌合并肝脏寡转移的治疗现状与进展,深入探讨其外科治疗的指征,评价治疗效果。

The prognosis of pancreatic cancer is the worst in all kinds of digestive tract tumors.Fifty percent of pancreatic cancer patients have distant metastasis at the time of diagnosis,and liver is the most common site of metastasis.For pancreatic cancer patients,the presence of distant metastasis has been always considered as an absolute contraindication for surgical resection.However,with the establishment of multidisciplinary team,especially the researches of chemotherapy and targeted drugs and the application of new chemotherapy regimens in recent years,there are more and more evidences which show the survival benefit of surgical resection for some selected patients with liver oligometastasis after systemic chemotherapy.In this paper,the authors review current situation and progress in the treatment strategy for pancreatic cancer with hepatic oligometastasis,further investigate the indication of surgical treatment and evaluate its clinical outcomes.