Contemporary Management of Localized Resectable Pancreatic Cancer.
Contemporary Management of Localized Resectable Pancreatic Cancer.
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DOI：
10.3390/cancers10010024
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发表时间：
2018-01-20
期刊：
影响因子：
5.2
通讯作者：
Mahipal A
中科院分区：
文献类型：
--
作者：
Kommalapati A;Tella SH;Goyal G;Ma WW;Mahipal A
胰腺癌是美国癌症死亡的第三大常见原因。切缘阴性的手术切除仍然是潜在治愈性治疗的基石，但在最初诊断时仅15-20%的患者有可能。越来越多的证据表明，新辅助方法可能会提高局部可切除和边缘可切除疾病的R 0切除率，并可能使局部晚期疾病提前分期以实现手术切除，但对生存率的影响尚待确定。尽管在过去十年中在开发有效的联合放化疗治疗方案、术前治疗策略和更好的围手术期护理方面取得了进展，但胰腺癌的预后仍然很差。目前正在做出巨大的努力，以优化新辅助治疗，具有更好的毒性特征，开发新的药物，成像技术和鉴定疾病的生物标志物。迫切需要我们对肿瘤微环境和分子病理学的理解取得进展，以促进针对这种情况的新型靶向和免疫疗法的开发。在这篇综述中，我们详细介绍了目前关于可切除的、边缘性可切除的和局部晚期胰腺癌的管理的文献，并重点讨论了该领域的未来发展方向。
Pancreatic cancer is the third most common cause of cancer deaths in the United States. Surgical resection with negative margins still constitutes the cornerstone of potentially curative therapy, but is possible only in 15–20% of patients at the time of initial diagnosis. Accumulating evidence suggests that the neoadjuvant approach may improve R0 resection rate in localized resectable and borderline resectable diseases, and potentially downstage locally advanced disease to achieve surgical resection, though the impact on survival is to be determined. Despite advancements in the last decade in developing effective combinational chemo-radio therapeutic options, preoperative treatment strategies, and better peri-operative care, pancreatic cancer continues to carry a dismal prognosis in the majority. Prodigious efforts are currently being made in optimizing the neoadjuvant therapy with a better toxicity profile, developing novel agents, imaging techniques, and identification of biomarkers for the disease. Advancement in our understanding of the tumor microenvironment and molecular pathology is urgently needed to facilitate the development of novel targeted and immunotherapies for this setting. In this review, we detail the current literature on contemporary management of resectable, borderline resectable and locally advanced pancreatic cancer with a focus on future directions in the field.
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影响因子：
3.7
作者：
Hsu CC;Herman JM;Corsini MM;Winter JM;Callister MD;Haddock MG;Cameron JL;Pawlik TM;Schulick RD;Wolfgang CL;Laheru DA;Farnell MB;Swartz MJ;Gunderson LL;Miller RC
通讯作者：
Miller RC
DOI：
10.1016/j.jamcollsurg.2014.02.023
发表时间：
2014-07-01
影响因子：
5.2
作者：
Cooper, Amanda B.;Holmes, Holly M.;Katz, Matthew H. G.
通讯作者：
Katz, Matthew H. G.
DOI：
10.1126/science.1198443
发表时间：
2011-03-25
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Beatty GL;Chiorean EG;Fishman MP;Saboury B;Teitelbaum UR;Sun W;Huhn RD;Song W;Li D;Sharp LL;Torigian DA;O'Dwyer PJ;Vonderheide RH
通讯作者：
Vonderheide RH
影响因子：
45.3
作者：
Corsini, Michele M.;Miller, Robert C.;Gunderson, Leonard L.
通讯作者：
Gunderson, Leonard L.
影响因子：
51.1
作者：
Hess, Viviane;Glimelius, Bengt;Herrmann, Richard
通讯作者：
Herrmann, Richard