Essential Update 2023/2024: Multidisciplinary Treatment for Invasive Intraductal Papillary Mucinous Carcinoma

IF 2.9 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Seiko Hirono
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Abstract

Invasive intraductal papillary mucinous carcinoma (IPMC) has a high malignant potential, with surgical resection being the only potentially curative treatment. However, even after surgical resection, recurrence occurs frequently and the prognosis is poor once recurrence develops. While retrospective studies aiming to achieve long-term survival in invasive IPMC patients have been reported, the rarity of invasive IPMC has resulted in small-scale datasets, leading to low levels of evidence. Consequently, the utility of adjuvant therapy after surgery, neoadjuvant therapy (NAT) before surgery, and treatments for postoperative recurrence in invasive IPMC remains unclear, with treatment strategies varying by institution—ranging from surgical resection alone to approaches based on conventional pancreatic cancer treatment. Recently, several large-scale multicenter studies on invasive IPMC have been reported. These studies suggested that while adjuvant therapy after surgery may not be beneficial for all invasive IPMC patients, it could potentially extend survival in cases with advanced-stage disease. Regarding NAT before surgery for invasive IPMC, the number of reported cases is extremely limited, and no definitive evidence has been established. For postoperative recurrence of invasive IPMC, some studies have indicated that administering treatment may prolong survival. Although these large-scale studies have gradually clarified certain characteristics of invasive IPMC, they are all retrospective in nature, resulting in a low level of evidence. To achieve long-term survival for invasive IPMC patients, large-scale prospective multicenter studies are needed in the future.

基本更新2023/2024:浸润性导管内乳头状粘液癌的多学科治疗
侵袭性导管内乳头状粘液癌(IPMC)具有很高的恶性潜能,手术切除是唯一可能治愈的治疗方法。然而,即使在手术切除后,复发也很频繁,一旦复发预后较差。虽然已有旨在实现侵袭性IPMC患者长期生存的回顾性研究报道,但侵袭性IPMC的罕见性导致数据集规模小,证据水平低。因此,侵袭性IPMC术后辅助治疗、术前新辅助治疗(NAT)和术后复发治疗的应用仍不清楚,治疗策略因机构而异——从单纯手术切除到基于传统胰腺癌治疗的方法。近年来,有创性IPMC的多中心大规模研究报道。这些研究表明,虽然手术后辅助治疗可能不是对所有侵袭性IPMC患者都有益,但它可能会延长晚期疾病患者的生存期。关于侵袭性IPMC术前NAT,报道的病例数量非常有限,没有明确的证据。对于侵袭性IPMC术后复发,一些研究表明给予治疗可以延长生存期。虽然这些大规模的研究逐渐明确了侵袭性IPMC的某些特征,但它们都是回顾性的,证据水平较低。为了实现侵袭性IPMC患者的长期生存,未来需要进行大规模的前瞻性多中心研究。
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来源期刊
Annals of Gastroenterological Surgery
Annals of Gastroenterological Surgery GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.30
自引率
11.10%
发文量
98
审稿时长
11 weeks
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