ABSTRACT
With the progress of imaging technology and the popularization of healthy examination, the detection rate of pancreatic cystic neoplasm(PCN) has increased significantly. PCN has complex disease spectrum, strong heterogeneity, and diverse surgical treatment strategies. Surgical timing and methods directly affect patients' prognosis. Therefore, how to identify malignant tumors and formulate reasonable treatment strategies are the keys to treat PCN. Many guidelines for clinical diagnosis and treatment of PCN have been released, but there are still many disputes about its surgical indications. Hence, fully assessing the surgical indications is of great significance to improve the PCN patients' prognosis. This paper deeply discusses on the surgical indications of PCN by reviewing the current clinical diagnosis, treatment and research progress of PCN, in order to standardize the diagnosis and treatment of PCN.
Subject(s)
Pancreatic Cyst , Pancreatic Neoplasms , Humans , Pancreas/pathology , Pancreatic Cyst/diagnosis , Pancreatic Cyst/surgery , Pancreatic Neoplasms/diagnosis , PrognosisABSTRACT
Pancreatic cancer is a highly malignant tumor in the digestive system.The role of neoadjuvant therapy in pancreatic cancer has been highlighted with the understanding of pancreatic cancer biological behavior and popularization of comprehensive treatment.Therefore,Study group of Pancreatic Surgery in China Society of Surgery of Chinese Medical Association and Pancreatic Disease Committee of China Research Hospital Association has formulated the guidelines for neoadjuvant therapy of pancreatic cancer in China(2020 edition).This guidelines elaborated key issues of the neoadjuvant therapy of pancreatic cancer,and provided reference for clinical practice.This article aims to interpret the guidelines about the preparation before neoadjuvant therapy, indication, regimen selection, therapeutic effect evaluation and surgery strategy, with further discussion about controversial issues of neoadjuvant therapy in pancreatic cancer.
Subject(s)
Neoadjuvant Therapy , Pancreatic Neoplasms , China , Humans , Pancreatic Neoplasms/therapy , Practice Guidelines as TopicABSTRACT
In recent years, more and more attention has been paid on the role of neoadjuvant therapy in the comprehensive treatment of pancreatic cancer. There is increasing evidence indicates that neoadjuvant therapy improves the R0 resection rate and patient's prognosis. However, the indication, therapy selection and efficacy evaluation of neoadjuvant therapy in patients with pancreatic cancer are still controversial, thus its clinical application is not very mature. This article aims to analyze the clinical implementation dilemma of neoadjuvant therapy for pancreatic cancer, and discuss the scientific and reasonable neoadjuvant treatment mode for pancreatic cancer patients.
Subject(s)
Neoadjuvant Therapy , Pancreatic Neoplasms , Antineoplastic Combined Chemotherapy Protocols , Humans , Pancreatic Neoplasms/drug therapy , PrognosisABSTRACT
The insulinoma, which is the most common pancreatic neuroendocrine tumor, can be misdiagnosed and mistreated easily.Recently, the misdiagnosis rate has decreased significantly owing to the establishment of diagnosis and treatment system.However, the misconception about its diagnosis and treatment still exists because the diagnosis and treatment level varies greatly among different centers.This article aims to summarize the experience in the diagnosis and treatment of insulinoma in Peking Union Medical College Hospital, and introduce the qualitative and localization diagnosis, surgical and interventional treatment and perioperative management about insulinoma, so as to standardize the diagnosis and treatment procedure in China.
Subject(s)
Insulinoma , Pancreatectomy , Pancreatic Neoplasms , China , Humans , Insulinoma/diagnosis , Insulinoma/surgery , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/surgery , Treatment OutcomeABSTRACT
Triple-negative breast cancer (TNBC) has attracted more attention both clinically and experimentally because of its high-risk biological characteristics and lacking of effective treatment method. The tumour characteristics, patterns of recurrence and metastasis, therapy methods and prognosis in younger TNBC patients have been widely formulated, but the relevant data of the elderly people are lacking. We conducted this retrospective study to compare and analyse the above-related characteristics between the younger and elderly patients with TNBC to estimate the relevance for the elderly TNBC patients. A total of 1489 female patients with primary breast cancer were diagnosed and treated at the department of General Surgery, the Chinese PLA General Hospital, China, from January 2004 to December 2008. In the 1489 patients, 302 patients (20.28%) with TNBC histopathologically confirmed were retrospectively analysed. The 302 TNBC patients were divided into two groups: the younger (<60 years) group and the elderly (≥60 years) group. The relevant characteristics of the two groups were compared. There were no statistically significant differences between the two groups in common clinical data of the patients, clinicopathological features of tumour and the features of local recurrences and metastases of tumour, and the 5-year disease-free survival and overall survival were all significantly higher in the elderly group than those in the younger group, although the elderly group patients accepted significantly less radiotherapy and chemotherapy than the younger group patients. The elderly and younger TNBC patients may belong to different subtypes of TNBC and we probably could take a more conservative and cautious attitude in choosing the post-operative adjuvant treatment for the elderly patients with TNBC.
