Role of surgery in pancreatic cancer

作     者：Trond A Buanes 

作者机构：Department of Hepato-Pancreatico-Biliary Surgery Oslo University Hospital Institute of Clinical Medicine Faculty of Medicine University of Oslo 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2017年第23卷第21期

页      面：3765-3770页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Adjuvant chemotherapy Neoadjuvant chemotherapy Metastasis Pancreatic cancer Patient reported outcome Survival 

摘      要：Treatment of pancreatic cancer is multimodal and surgery is an essential part,mandatory for curative *** chemotherapy is essential,and serious postoperative complications or rapid disease progression may preclude completion of multimodal *** sequence of treatment interventions has therefore become an important concern,and numerous ongoing randomized controlled trials compare clinical outcome after upfront surgery and neoadjuvant treatment with subsequent *** previous years,borderline resectable and locally advanced pancreatic cancer was most often considered *** effective chemotherapy together with the latest improvements in surgical expertise has resulted in extended operations,pushing the borders of *** resections with or without resection of major mesen-teric vessels are now performed in numerous patients,resulting in better outcome,recorded as overall survival and/or patient reported *** postoperative morbidity increases concurrently,and clinical benefit must be carefully evaluated against risk of potential harm,associated with new comprehensive multimodal treatment *** though cost/utility analyses are deficient,extended surgery has resulted in signifi-cantly longer and better life for many patients with no other treatment *** selection of patients to surgery and/or chemotherapy will in the near future be possible,based on better tumor biology *** available biomarkers enabling personalized treatment are forthcoming,but these options are still *** importance of surgical resection for each patient’s prognosis is presently increasing,justifying sustained expansion of the surgical treatment modality.