以门静脉系统重建为标准的交界可切除胰腺癌综合诊疗体系的探讨

A comprehensive diagnosis and treatment system for borderline resectable pancreatic cancer based on portal vein reconstruction

交界可切除胰腺癌是介于可切除和不可切除胰腺癌之间的一个特殊分型,尽管肿瘤在外科手术技术上适合切除,但往往预示着术后切缘阳性的风险增加。目前交界可切除胰腺癌尚无最佳的诊断标准和治疗方案。随着多学科诊治理念的推广,新辅助治疗在交界可切除胰腺癌中的应用逐渐普及,并在部分中心获得了良好效果。但对于对放化疗不敏感的交界可切除胰腺癌患者,较长的新辅助治疗时限可能会延误最佳的手术时机。本文对交界可切除胰腺癌的定义、分类标准、最新诊疗进展进行总结,并结合我中心的临床实践经验,探讨适合该类患者的综合治疗模式。

Borderline resectable pancreatic cancer is a special subtype between resectable and unresectable pancreatic cancer.Although the tumor is technically suitable for resection,there is increased risk of positive margin after surgery.At present,there is no optimal diagnostical criteria and treatment options for borderline resectable pancreatic cancer.With the popularization of the concept of multidisciplinary diagnosis and treatment,neoadjuvant therapy has been widely used in borderline resectable pancreatic cancer,and received good outcomes in some centers.However,for patients with borderline resectable pancreatic cancer who are not sensitive to radiotherapy and chemotherapy,long time of neoadjuvant therapy may delay the best time for surgery.This article summarized the definition,classification criteria and the latest diagnosis and treatment progress of borderline resectable pancreatic cancer,and discussed the comprehensive treatment mode suitable for this kind of patients combined with the clinical experience of our center.