Isolated lung metastases from pancreatic ductal adenocarcinoma (PDAC): Diagnostic and therapeutic challenges of a different disease

IF 3 3区 医学 Q2 ONCOLOGY Seminars in oncology Pub Date : 2024-06-01 DOI:10.1053/j.seminoncol.2024.04.001
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Abstract

Pancreatic ductal adenocarcinoma (PDAC) has a dismal prognosis, mostly due to the high rate of distant dissemination. However, growing evidence shows that isolated lung recurrence or metastases (ILM) from PDAC are not only less common, but also correlated with a better prognosis. Lung-only recurrence after surgery occurs later in time and is associated with more favorable prognostic characteristics of the primary tumor. Moreover, recent findings suggest that this specific site of metastases is characterized by an immunologically “hot” microenvironment and a more favorable molecular profile that could possibly justify its clinical behavior. Thus, ILM from PDAC emerge as a distinct entity, that might also benefit from a different therapeutic approach, possibly with the integration of surgery and de-intensified chemotherapy regimens, especially in selected patients. In this review we delve into the current scientific evidence on the clinical and biological characteristics of isolated LM from PDAC, also focusing on concerns with their diagnostic process and the therapeutic options for the management of this subset of patients.

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胰腺导管腺癌(PDAC)的肺转移:不同疾病的诊断和治疗难题
胰腺导管腺癌(PDAC)的预后很差,主要原因是远处播散率很高。然而,越来越多的证据表明,PDAC 的肺部孤立复发或转移(ILM)不仅不常见,而且预后较好。术后仅肺部复发发生的时间较晚,且与原发肿瘤更有利的预后特征相关。此外,最近的研究结果表明,这一特定部位的转移瘤具有免疫 "热 "微环境和更有利的分子特征,这可能会证明其临床表现的合理性。因此,来自 PDAC 的 ILM 是一个独特的实体,它也可能受益于不同的治疗方法,可能是手术和去强化化疗方案的结合,尤其是在选定的患者中。在这篇综述中,我们将深入探讨目前有关 PDAC 分离出的 LM 的临床和生物学特征的科学证据,并重点关注其诊断过程和治疗该亚群患者的治疗方案。
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来源期刊
Seminars in oncology
Seminars in oncology 医学-肿瘤学
CiteScore
6.60
自引率
0.00%
发文量
58
审稿时长
104 days
期刊介绍: Seminars in Oncology brings you current, authoritative, and practical reviews of developments in the etiology, diagnosis and management of cancer. Each issue examines topics of clinical importance, with an emphasis on providing both the basic knowledge needed to better understand a topic as well as evidence-based opinions from leaders in the field. Seminars in Oncology also seeks to be a venue for sharing a diversity of opinions including those that might be considered "outside the box". We welcome a healthy and respectful exchange of opinions and urge you to approach us with your insights as well as suggestions of topics that you deem worthy of coverage. By helping the reader understand the basic biology and the therapy of cancer as they learn the nuances from experts, all in a journal that encourages the exchange of ideas we aim to help move the treatment of cancer forward.
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