New advances in the treatment of pancreatic carcinoma
10.3760/cma.j.issn.1673-9752.2013.01.005
- VernacularTitle:胰腺癌外科治疗新进展
- Author:
Yinmo YANG
- Publication Type:Journal Article
- Keywords:
Pancreatic neoplasms;
Lymphadenectomy;
Neoadjuvant therapy;
Mesopancreas;
Radical resection
- From:
Chinese Journal of Digestive Surgery
2013;(1):16-20
- CountryChina
- Language:Chinese
-
Abstract:
Pancreatic carcinoma is still a challenging disease.Although there is no randomized controlled trial (RCT) results,neoadjuvant therapy is encouraged to perform on patients with borderline resectable or resectable pancreatic cancers,which could probably increase the Ro resection rates.There has been some modifications about resection approach in recent years,for example,artery first,hanging maneuver,uncinate process first,etc,which seem as safe and effective options.Because of the modification of pathologic classification of R0 and R1 resection for pancreatic cancer,the clinical outcomes of R1 resection need to be reevaluated.The extent of lymphadenectomy in pancreaticoduodenectomy remains controversial.Based on several RCT reports,dissection of 2nd group of lymph nodes is recommended according to the Japan Pancreas Society classification.The discussion and clinical application about the concept of mesopancreas will help to improve the status of retroperitoneal margins via standardized surgical procedures.
