The incidence of pancreatic cancer has been rising worldwide,and its clinical diagnosis and treatment remain a great challenge.To present the update and improvements in the clinical diagnosis and treatment of pancreat...The incidence of pancreatic cancer has been rising worldwide,and its clinical diagnosis and treatment remain a great challenge.To present the update and improvements in the clinical diagnosis and treatment of pancreatic cancer in recent years,Chinese Pancreatic Association,the Chinese Society of Surgery,Chinese Medical Association revised the Guidelines for the Diagnosis and Treatment of Pancreatic Cancer in China(2014)after reviewing evidence-based and problem-oriented literature published during 2015-2021,mainly focusing on highlight issues regarding diagnosis and surgical treatment of pancreatic cancer,conversion strategies for locally advanced pancreatic cancer,treatment of pancreatic cancer with oligo metastasis,adjuvant and neoadjuvant therapy,standardized processing of surgical specimens and evaluation of surgical margin status,systemic treatment for unresectable pancreatic cancer,genetic testing,as well as postoperative follow up of patients with pancreatic cancer.Forty recommendation items were finally proposed based on the above issues,and the quality of evidence and strength of recommendations were graded using the Grades of Recommendation,Assessment,Development,and Evaluation system.This guideline aims to standardize the clinical diagnosis and therapy,especially surgical treatment of pancreatic cancer in China,and further improve the prognosis of patients with pancreatic cancer.展开更多
We introduced a 61-year-old male with ductal adenocarcinoma of the prostate who underwent a tortuous diagnosis and treatment.Multi-disciplinary team meetings organized by our hospital have shown great value in the who...We introduced a 61-year-old male with ductal adenocarcinoma of the prostate who underwent a tortuous diagnosis and treatment.Multi-disciplinary team meetings organized by our hospital have shown great value in the whole process.The patient presented with gross hematuria accompanied by frequent urination initially,and was diagnosed with ductal adenocarcinoma of the prostate involving right seminal vesicle gland and urethra by urethroscopy biopsy.The clinical stage of tumor was T3bN0M0.After 4 cycles of neoadjuvant chemotherapy,the tumor shrank significantly and the patient underwent a laparoscopic radical prostatectomy.But the patient declined to continue chemotherapy postoperatively.After 10 months,the serum prostatic specific antigen increased to 0.05 ng/mL,and multiple metastases were found in the patient's bilateral lungs.However,an unexpected diagnosis of seminal vesicle adenocarcinoma was put forward from another hospital after supplementary pathologic immunohistochemical examination.Then,after careful discussion and demonstration by our multi-disciplinary team experts,we insisted on the diagnosis of ductal adenocarcinoma of the prostate and suggested that the original regimen of chemotherapy should be continued.Up-to-date,14 months after the operation,the patient continues to survive while undergoing ongoing active treatment as recommended.展开更多
Objective:Pancreatic cancer is one of the most aggressive digestive system malignant tumors,and its clinical diagnosis and treatment are still challenging.To further understand the current status and improve the multi...Objective:Pancreatic cancer is one of the most aggressive digestive system malignant tumors,and its clinical diagnosis and treatment are still challenging.To further understand the current status and improve the multidisciplinary collaboration for diagnosis and treatment of pancreatic cancer in China,we conducted an online questionnaire survey on the diagnosis and treatment status of pancreatic cancer in public tertiary hospitals of China in 2021.Methods:In this cross-sectional questionnaire-based,observational study,online questionnaires with real-name authentication were used to gather data from 500 clinicians,50 pharmacists,and 1000 pancreatic cancer patients in tertiary general hospitals or cancer hospitals nationwide.Results:A total of 485 valid questionnaires were obtained from the clinicians,majority of whom were from economically better developed regions or cities of China.There were multi-disciplinary team treatment(MDT)clinics for pancreatic cancer patients in 60%of the hospitals.Minimally invasive surgeries could be performed in all the surveyed hospitals.However,open surgery was still the mainstream choice in most cases.Gemcitabine-based chemotherapy was the most popular first-line adjuvant regimen for pancreatic cancer.A total of 50 valid questionnaires were collected from pharmacists,48%of them are not satisfactory with the efficacy of the chemotherapeutic drugs,and myelosuppression,liver,and renal damage were the most concerning side effects.In total,1011 valid questionnaires were collected from the patients.Approximately,48.4%of the patients did not know about pancreatic cancer before becoming ill.Over 80%of pancreatic cancer patients reported poor to very poor health-related quality of life,and the estimated overall medical expenses were within<400,000($58823.53)in 80%of the patients.Clinicians,pharmacists,and patients believe that popularizing scientific knowledge of pancreatic cancer,constructing MDT clinics and fast-lane system,and conducting clinical research will help further improve the diagnosis and treatment of pancreatic cancer.Conclusions:The MDT clinics for pancreatic cancer have been well developed in most of the public tertiary hospitals.Minimally invasive pancreatic surgery has developed rapidly in China;however,open surgery is still the mainstream choice for pancreatic cancer.The proportion of adjuvant treatment has been significantly improved,and the gemcitabine-based regimen is the most commonly used first-line regimen.Most of the public still lacks the general knowledge of pancreatic cancer,needing further popularization.The construction of a fast-lane treatment system and conducting of high-level clinical studies are the warm expectations of the clinicians and patients.The real-world situation of the diagnosis and treatment of pancreatic cancer in the other types of hospitals of China needs further exploration.展开更多
文摘The incidence of pancreatic cancer has been rising worldwide,and its clinical diagnosis and treatment remain a great challenge.To present the update and improvements in the clinical diagnosis and treatment of pancreatic cancer in recent years,Chinese Pancreatic Association,the Chinese Society of Surgery,Chinese Medical Association revised the Guidelines for the Diagnosis and Treatment of Pancreatic Cancer in China(2014)after reviewing evidence-based and problem-oriented literature published during 2015-2021,mainly focusing on highlight issues regarding diagnosis and surgical treatment of pancreatic cancer,conversion strategies for locally advanced pancreatic cancer,treatment of pancreatic cancer with oligo metastasis,adjuvant and neoadjuvant therapy,standardized processing of surgical specimens and evaluation of surgical margin status,systemic treatment for unresectable pancreatic cancer,genetic testing,as well as postoperative follow up of patients with pancreatic cancer.Forty recommendation items were finally proposed based on the above issues,and the quality of evidence and strength of recommendations were graded using the Grades of Recommendation,Assessment,Development,and Evaluation system.This guideline aims to standardize the clinical diagnosis and therapy,especially surgical treatment of pancreatic cancer in China,and further improve the prognosis of patients with pancreatic cancer.
文摘We introduced a 61-year-old male with ductal adenocarcinoma of the prostate who underwent a tortuous diagnosis and treatment.Multi-disciplinary team meetings organized by our hospital have shown great value in the whole process.The patient presented with gross hematuria accompanied by frequent urination initially,and was diagnosed with ductal adenocarcinoma of the prostate involving right seminal vesicle gland and urethra by urethroscopy biopsy.The clinical stage of tumor was T3bN0M0.After 4 cycles of neoadjuvant chemotherapy,the tumor shrank significantly and the patient underwent a laparoscopic radical prostatectomy.But the patient declined to continue chemotherapy postoperatively.After 10 months,the serum prostatic specific antigen increased to 0.05 ng/mL,and multiple metastases were found in the patient's bilateral lungs.However,an unexpected diagnosis of seminal vesicle adenocarcinoma was put forward from another hospital after supplementary pathologic immunohistochemical examination.Then,after careful discussion and demonstration by our multi-disciplinary team experts,we insisted on the diagnosis of ductal adenocarcinoma of the prostate and suggested that the original regimen of chemotherapy should be continued.Up-to-date,14 months after the operation,the patient continues to survive while undergoing ongoing active treatment as recommended.
文摘Objective:Pancreatic cancer is one of the most aggressive digestive system malignant tumors,and its clinical diagnosis and treatment are still challenging.To further understand the current status and improve the multidisciplinary collaboration for diagnosis and treatment of pancreatic cancer in China,we conducted an online questionnaire survey on the diagnosis and treatment status of pancreatic cancer in public tertiary hospitals of China in 2021.Methods:In this cross-sectional questionnaire-based,observational study,online questionnaires with real-name authentication were used to gather data from 500 clinicians,50 pharmacists,and 1000 pancreatic cancer patients in tertiary general hospitals or cancer hospitals nationwide.Results:A total of 485 valid questionnaires were obtained from the clinicians,majority of whom were from economically better developed regions or cities of China.There were multi-disciplinary team treatment(MDT)clinics for pancreatic cancer patients in 60%of the hospitals.Minimally invasive surgeries could be performed in all the surveyed hospitals.However,open surgery was still the mainstream choice in most cases.Gemcitabine-based chemotherapy was the most popular first-line adjuvant regimen for pancreatic cancer.A total of 50 valid questionnaires were collected from pharmacists,48%of them are not satisfactory with the efficacy of the chemotherapeutic drugs,and myelosuppression,liver,and renal damage were the most concerning side effects.In total,1011 valid questionnaires were collected from the patients.Approximately,48.4%of the patients did not know about pancreatic cancer before becoming ill.Over 80%of pancreatic cancer patients reported poor to very poor health-related quality of life,and the estimated overall medical expenses were within<400,000($58823.53)in 80%of the patients.Clinicians,pharmacists,and patients believe that popularizing scientific knowledge of pancreatic cancer,constructing MDT clinics and fast-lane system,and conducting clinical research will help further improve the diagnosis and treatment of pancreatic cancer.Conclusions:The MDT clinics for pancreatic cancer have been well developed in most of the public tertiary hospitals.Minimally invasive pancreatic surgery has developed rapidly in China;however,open surgery is still the mainstream choice for pancreatic cancer.The proportion of adjuvant treatment has been significantly improved,and the gemcitabine-based regimen is the most commonly used first-line regimen.Most of the public still lacks the general knowledge of pancreatic cancer,needing further popularization.The construction of a fast-lane treatment system and conducting of high-level clinical studies are the warm expectations of the clinicians and patients.The real-world situation of the diagnosis and treatment of pancreatic cancer in the other types of hospitals of China needs further exploration.
