Pancreatic cancer is characterized by high malignancy and difficult early diag-nosis, with the majority of patients presenting at advanced, unresectable stages at the time of initial diagnosis. The efficacy of conventional treatments, including surgery, radiotherapy, and chemo-therapy, has reached a therapeutic plateau. The concept of precision medicine has gradually infiltrated the diagnosis and treatment of pancreatic cancer, driving the advancement of individua-lized therapies. Large-scale, multi-center studies have significantly advanced the molecular classifica-tion of pancreatic cancer, providing a basis for personalized treatment. Minimally invasive surgery, especially robotic surgery, has seen significant development and is increasingly entering clinical practice. The development of personalized drug screening, targeted therapy, and immunotherapy has paved new avenues for precision treatment. The authors review the latest research progress both domestically and internationally, discussing the application of precision medicine in the treat-ment of pancreatic cancer, aiming to improve patient prognosis.

The onset of pancreatic cancer is insidious, and most patients have accompanied by distant metastasis at the time of definite diagnosis. Previously, it was believed that regardless of the size, number and location of metastases, the surgical benefits of patients with metastatic pancreatic cancer were extremely limited. However, with the promotion of the concept of oligometastasis in recent years, an increasing number of studies have confirmed that surgical resection after induction therapy can significantly improve the clinical prognosis in some highly selected patients with oligometastatic disease of pancreatic cancer. However, there still remains many controversies about the clear definition, surgical treatment and perioperative management of oligometastatic disease of pancreatic cancer. Therefore, based on the latest research progress, this article proposes to discuss the related hot topics and disputes in the field of oligometastatic disease of pancreatic cancer for purpose of promoting the standardization of the treatment of oligometastatic disease of pancreatic cancer.

In recent years， significant progress has been made in the standardized diagnosis and treatment of pancreatic cancer in China. From the lack of treatment options and poor drug efficacy at the beginning to the current comprehensive treatment modality integrating surgery， chemotherapy， radiotherapy， immunotherapy， and targeted therapy under multidisciplinary decision-making， the diagnosis and treatment of pancreatic cancer has gradually achieved higher levels of individualization， refinement， and precision. With reference to the latest evidence-based medical data， this article discusses the hot topics in the diagnosis and treatment of pancreatic cancer and explores the future development directions of this field.

This article reviews the research advances in the characteristics and application progress of various new models for preclinical cancer research on pancreatic cancer， analyzes and discusses the history， current research status， and advantages and disadvantages of new models of pancreatic cancer， including patient-derived tissue xenograft， conditional reprogramming， and patient derived organoids， and it also reviews the studies that have achieved clinical transformation from preclinical models and proposes possible research prospects in the future.

ObjectiveTo compare and analyze the clinical application of robot-assisted parenchymal-sparing pancreatectomy （R-PSP） and laparoscopic parenchymal-sparing pancreatectomy （L-PSP） in the treatment of pancreatic neuroendocrine neoplasm （pNEN）， and to evaluate the safety and efficacy of the R-PSP procedure. MethodsA retrospective analysis was performed for the clinical data of pNEN patients who underwent parenchymal-sparing pancreatectomy in Department of General Surgery， Peking Union Medical College Hospital， Peking Union Medical College， Chinese Academy of Medical Sciences， from December 2017 to August 2023， and according to the minimally invasive surgical procedure， they were divided into R-PSP group and L-PSP group. R-PSP and L-PSP were compared in terms of the efficacy of minimally invasive procedure， the outcome of postoperative complications， and oncological efficacy. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups； the Mann-Whitney U test was used for comparison of ranked data between two groups. ResultsA total of 45 pNEN patients were included， with 9 in the R-PSP group and 36 in the L-PSP group， and there were no significant differences in baseline data between the two groups （all P>0.05）. There were no significant differences between the two groups in time of operation， intraoperative blood loss， intraoperative blood transfusion， and the rate of conversion to laparotomy （all P>0.05）. Compared with the L-PSP group， the R-PSP group had a significantly longer length of postoperative hospital stay ［10.00 （9.00‍ ‍—‍ ‍15.00） days vs 7.50 （6.00‍ ‍—‍ ‍10.00） days， Z=-2.356， P=0.017］ and significantly higher hospital costs ［86 610.44 （81 905.39‍ ‍—‍ ‍114 401.24） yuan vs 38 781.20 （31 708.39‍ ‍—‍ ‍50 514.76） yuan， Z=-4.001， P<0.001］. There were no significant differences between the two groups in the incidence rates of serious postoperative complications （Clavien-Dindo grade ≥Ⅲ）， clinically relevant pancreatic fistula， delayed gastric emptying， and intra-abdominal infection （all P>0.05）. The postoperative 90-day mortality rate was 0% for both groups. ConclusionR-PSP has acceptable safety and efficacy in pNEN patients in clinical practice.

Pancreatic cancer is characterized by high malignancy and difficult early diag-nosis, with the majority of patients presenting at advanced, unresectable stages at the time of initial diagnosis. The efficacy of conventional treatments, including surgery, radiotherapy, and chemo-therapy, has reached a therapeutic plateau. The concept of precision medicine has gradually infiltrated the diagnosis and treatment of pancreatic cancer, driving the advancement of individua-lized therapies. Large-scale, multi-center studies have significantly advanced the molecular classifica-tion of pancreatic cancer, providing a basis for personalized treatment. Minimally invasive surgery, especially robotic surgery, has seen significant development and is increasingly entering clinical practice. The development of personalized drug screening, targeted therapy, and immunotherapy has paved new avenues for precision treatment. The authors review the latest research progress both domestically and internationally, discussing the application of precision medicine in the treat-ment of pancreatic cancer, aiming to improve patient prognosis.

The onset of pancreatic cancer is insidious, and most patients have accompanied by distant metastasis at the time of definite diagnosis. Previously, it was believed that regardless of the size, number and location of metastases, the surgical benefits of patients with metastatic pancreatic cancer were extremely limited. However, with the promotion of the concept of oligometastasis in recent years, an increasing number of studies have confirmed that surgical resection after induction therapy can significantly improve the clinical prognosis in some highly selected patients with oligometastatic disease of pancreatic cancer. However, there still remains many controversies about the clear definition, surgical treatment and perioperative management of oligometastatic disease of pancreatic cancer. Therefore, based on the latest research progress, this article proposes to discuss the related hot topics and disputes in the field of oligometastatic disease of pancreatic cancer for purpose of promoting the standardization of the treatment of oligometastatic disease of pancreatic cancer.

As pancreatic cancer (PC) is highly malignant, its patients tend to develop metastasis at an early stage and show a poor response to conventional chemotherapies. First-line chemotherapies for PC, according to current guidelines, include fluoropyrimidine- and gemcitabine-based regimens. Accumulating research on drug resistance has shown that biochemical metabolic aberrations in PC, especially those involving glycolysis and glutamine metabolism, are highly associated with chemoresistance. Additionally, lipid metabolism is a major factor in chemoresistance. However, emerging compounds that target these key metabolic pathways have the potential to overcome chemoresistance. This review summarizes how PC develops chemoresistance through aberrations in biochemical metabolism and discusses novel critical targets and pathways within cancer metabolism for new drug research.

Pancreatic surgery is one of the most challenging specialties in general surgery. Due to the variety of pancreatic diseases, the difficulty of surgery, and the differences in diagnosis and treatment among different diseases, treatment strategies for these diseases remain controversial. From the aspects of surgical treatment such as pancreatitis, pancreatic cystic neoplasms, pancreatic neuroendocrine neoplasms, and pancreatic cancer, as well as neoadjuvant therapy, adjuvant therapy, immunotherapy, and targeted therapy. We review and summarize the frontier progress of clinical and translational research in pancreatic surgery in 2023, in order to further standardize the diagnosis and treatment of pancreatic surgery.

Pancreatic cancer, a highly malignant digestive system tumor, presents significant challenges in surgical treatment and generally has a poor prognosis. Luckily, the rapid development of medical artificial intelligence has facilitated its application in areas related to pancreatic cancer, including preoperative imaging diagnostics, rapid pathological diagnosis, surgical robotic systems, and the training of pancreatic surgery specialists. In this paper, we review the latest advancements in the application of medical artificial intelligence in pancreatic cancer, aiming to promote the deep integration of artificial intelligence in the field of pancreatic cancer surgery.