系统治疗时代胰腺癌外科治疗策略:“surgery first”还是“surgery last”

Management strategies of pancreatic carcinoma in the era of systemic therapy:surgery first or surgery last

尽管近年来胰腺癌的手术切除率与手术安全性显著提高,但患者远期预后仍无显著改善。在目前多学科诊断与治疗的背景下,胰腺癌作为系统性疾病,传统“surgery first”的治疗策略面临质疑与挑战。对于局部进展期、交界可切除及合并有高复发风险的可切除胰腺癌,提倡先行系统治疗即“surgery last”的治疗策略;对于生物学行为良好的可切除胰腺癌,宜行“surgery first”治疗策略。

Although the resection rate and surgical safety of pancreatic cancer has been significantly increased in recent years,however,the long-term prognosis of the patient remains dismal.In the era of multidisciplinary diagnosis and treatment,"surgery first",the traditional management strategy of pancreatic carcinoma,has been questioned and challenged because pancreatic carcinoma should be regarded as a systemic disease.For patients with locally advanced,borderline resectable or resectable tumors with high risks of recurrence,the option of"surgery last"should be advocated,which promotes systemic therapy.For patients with resectable tumors with better biological behaviors,the option of"surgery first"should be recommended.