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Surgery for oligometastasis of pancreatic cancer

Chinese Journal of Cancer Research 2015年第4期27卷 358-367页

作者： Fengchun Lu Katherine E.poruk Matthew J.Weiss Department of General Surgery Union Hospital Fujian Medical University Department of Surgery The Sol Goldman Pancreatic Cancer Research Center The Johns Hopkins University School of Medicine

The incidence of pancreatic adenocarcinoma（PDAC） has steadily increased over the past several decades. The majority of PDAC patients will present with distant metastases, limiting surgical management in this population. Hepatectomy and pulmonary metastasectomy（PM） has been well established for colorectal cancer patients with isolated, resectable hepatic or pulmonary metastatic disease. Recent advancements in effective systemic therapy for PDAC have led to the selection of certain patients where metastectomy may be potentially indicated. However, the indication for resection of oligometastases in PDAC is not well defined. This review will discuss the current literature on the surgical management of metastatic disease for PDAC with a specific focus on surgical resection for isolated hepatic and pulmonary metastases.

关键词： Pancreatic cancer(PC) oligometastasis hepatic metastasis pulmonary metastasis surgical management

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Pancreatic cancer surgery: past, present, and future

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Chinese Journal of Cancer Research 2015年第4期27卷 332-332页

作者： James F.Griffin Katherine E.poruk Christopher L.Wolfgang Department of Surgery The Sol Goldman Pancreatic Cancer Research Center The Johns Hopkins University School of Medicine

The history of pancreatic cancer surgery, though fraught with failure and setbacks, is punctuated by periods of incremental progress dependent upon the state of the art and the mettle of the surgeons daring enough to attempt it. Surgical anesthesia and the aseptic techniques developed during the latter half of the 19 th century were instrumental in establishing a viable setting for pancreatic surgery to develop. Together, they allowed for bolder interventions and improved survival through the postoperative period. Surgical management began with palliative procedures to address biliary obstruction in advanced disease. By the turn of the century, surgical pioneers such as Alessandro Codivilla and Walther Kausch were demonstrating the technical feasibility of pancreatic head resections and applying principles learned from palliation to perform complicated anatomical reconstructions. Allen O. Whipple, the namesake of the pancreaticoduodenectomy（PD）, was the first to take a systematic approach to refining the procedure. Perhaps his greatest contribution was sparking a renewed interest in the surgical management of periampullary cancers and engendering a community of surgeons who advanced the field through their collective efforts. Though the work of Whipple and his contemporaries legitimized PD as an accepted surgical option, it was the establishment of high-volume centers of excellence and a multidisciplinary approach in the later decades of the 20^th century that made it a viable surgical option. Today, pancreatic surgeons are experimenting with minimally invasive surgical techniques, expanding indications for resection, and investigating new methods for screening and early detection. In the future, the effective management of pancreatic cancer will depend upon our ability to reliably detect the earliest cancers and precursor lesions to allow for truly curative resections.

关键词： Whipple pancreaticoduodenectomy(PD) pancreatic cancer pancreatic ductal adenocarcinoma(PDAC) surgical history history of pancreatic cancer Codivilla Kausch William Halsted John Cameron

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