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https://www.readbyqxmd.com/read/28646282/surgery-for-pancreatic-ductal-adenocarcinoma
#1
REVIEW
R Vera, L Díez, E Martín Pérez, J C Plaza, A Sanjuanbenito, A Carrato
Surgical resection is the only potentially curative option in the treatment of pancreatic ductal adenocarcinoma. Preoperative radiological imaging allows to rule out the presence of metastases. Three resectability categories are established based on the radiological findings depending on the degree of contact between the tumor and the blood vessels. Histological confirmation of malignancy is only required in cases of borderline or non-resectable tumors, prior to neoadjuvant treatment initiation. Diagnostic laparoscopy is recommended in the presence of large tumors of the body or tail and in borderline tumors to explore the possibility of resection and to apply treatment with curative intent, as well as in those cases with high level of biomarkers to rule out peritoneal involvement...
June 23, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28639410/long-term-survival-benefit-of-upfront-chemotherapy-in-patients-with-newly-diagnosed-borderline-resectable-pancreatic-cancer
#2
Bikram Shrestha, Yifei Sun, Farzana Faisal, Victoria Kim, Kevin Soares, Alex Blair, Joseph M Herman, Amol Narang, Avani S Dholakia, Lauren Rosati, Amy Hacker-Prietz, Linda Chen, Daniel A Laheru, Ana De Jesus-Acosta, Dung T Le, Ross Donehower, Nilofar Azad, Luis A Diaz, Adrian Murphy, Valerie Lee, Elliot K Fishman, Ralph H Hruban, Tingbo Liang, John L Cameron, Martin Makary, Matthew J Weiss, Nita Ahuja, Jin He, Christopher L Wolfgang, Chiung-Yu Huang, Lei Zheng
The use of neoadjuvant chemotherapy or radiation for borderline resectable pancreatic adenocarcinoma (BL-PDAC) is increasing. However, the impact of neoadjuvant chemotherapy and radiation therapy on the outcome of BL-PDAC remains to be elucidated. We performed a retrospective analysis of 93 consecutive patients who were diagnosed with BL-PDAC and primarily followed at Johns Hopkins Hospital between February 2007 and December 2012. Among 93 patients, 62% received upfront neoadjuvant chemotherapy followed by chemoradiation, whereas 20% received neoadjuvant chemoradiation alone and 15% neoadjuvant chemotherapy alone...
June 21, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28638216/role-of-surgery-in-pancreatic-cancer
#3
EDITORIAL
Trond A Buanes
Treatment of pancreatic cancer is multimodal and surgery is an essential part, mandatory for curative potential. Also chemotherapy is essential, and serious postoperative complications or rapid disease progression may preclude completion of multimodal treatment. The sequence of treatment interventions has therefore become an important concern, and numerous ongoing randomized controlled trials compare clinical outcome after upfront surgery and neoadjuvant treatment with subsequent resection. In previous years, borderline resectable and locally advanced pancreatic cancer was most often considered unresectable...
June 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28620900/new-treatment-options-and-management-considerations-in-borderline-resectable-pancreatic-cancer
#4
REVIEW
Zeljka Jutric, Laleh G Melstrom
In the United States, cancer of the pancreas accounts for nearly 40,000 deaths annually and is the fourth leading cause of cancer-related mortality. The vast majority of patients present with metastatic or unresectable disease. Only 20% of patients are candidates for surgery, and therefore curable. The 5-year survival rate for patients with pancreatic adenocarcinoma is only 6%, with surgical resection being essential for long-term survival. Recent research has identified a precise subset of patients with borderline resectable pancreatic cancer for whom resection yielding durable survival is possible...
June 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28612203/neoadjuvant-treatment-for-borderline-and-resectable-pancreatic-ductal-adenocarcinoma
#5
REVIEW
R Álvarez, I Alés, R Díaz, B G de Paredes, M Hidalgo
Nowadays and given the improvement in response rate with the new schemes of treatment with chemotherapy, the interest in neoadjuvant treatment for pancreatic ductal adenocarcinoma, allowing the early application of systemic therapies, has also increased. However, treatment selection fundamentally depends on decisions taken by multidisciplinary committees due to the absence of randomized trials on this indication and because the available evidence is based primarily on small studies. The present manuscript tries to establish recommendations based on the available evidence and expert opinion to correctly select the indication, the type of treatment, as well as its duration and how to correctly follow-up patients during treatment with chemotherapy...
June 13, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28608409/neoadjuvant-chemoradiotherapy-of-pancreatic-cancer-induces-a-favorable-immunogenic-tumor-microenvironment-associated-with-increased-major-histocompatibility-complex-class-i-related-chain-a-b-expression
#6
Takashi Murakami, Yuki Homma, Ryusei Matsuyama, Ryutaro Mori, Kentaro Miyake, Yusaku Tanaka, Kanechika Den, Yoji Nagashima, Masatoshi Nakazawa, Yukihiko Hiroshima, Michio Ueda, Kuniya Tanaka, Robert M Hoffman, Michael Bouvet, Itaru Endo
BACKGROUND: Damage-associated molecular patterns (DAMPs) are related to immune responses in malignant tumors including tumor-infiltrating lymphocytes (TILs). The aim of the present study was to determine the relationship between expression of components of DAMPs and TILs in pancreatic cancer patients who underwent neoadjuvant chemoradiotherapy (NACRT) versus those who did not. METHODS: NACRT was administered to 51 patients with borderline-resectable pancreatic cancer and not to 33 patients with resectable pancreatic cancer...
June 12, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28608305/quality-assurance-of-the-preopanc-trial-2012-003181-40-for-preoperative-radiochemotherapy-in-pancreatic-cancer-the-dummy-run
#7
Eva Versteijne, Eelco Lens, Astrid van der Horst, Arjan Bel, Jorrit Visser, Cornelis J A Punt, Mustafa Suker, Casper H J van Eijck, Geertjan van Tienhoven
BACKGROUND: The Dutch Pancreatic Cancer Group initiated the national, multicentre, controlled PREOPANC trial, randomising between preoperative radiochemotherapy and direct explorative laparotomy for patients with (borderline) resectable pancreatic cancer. The aim of this dummy run is to evaluate compliance with the radiotherapy protocol of this trial, and the quality of delineation and radiation plans. METHODS: Eleven radiation oncology departments open for accrual of patients in the PREOPANC trial were provided with all necessary information of a selected 'dummy' patient...
June 12, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28608121/a-prospective-phase-ii-trial-of-neoadjuvant-s-1-with-concurrent-hypofractionated-radiotherapy-in-patients-with-resectable-and-borderline-resectable-pancreatic-ductal-adenocarcinoma
#8
Keiichi Okano, Hironobu Suto, Minoru Oshima, Eri Maeda, Naoki Yamamoto, Keitaro Kakinoki, Hideki Kamada, Tsutomu Masaki, Shigeo Takahashi, Toru Shibata, Yasuyuki Suzuki
BACKGROUND: The ideal neoadjuvant treatment protocol for patients with pancreatic cancer (PDAC) remains unclear. We evaluated the efficacy and safety of neoadjuvant hypofractionated chemoradiotherapy with S-1 for patients with resectable (R) and borderline resectable (BR) PDAC. METHODS: Eligibility criteria included patients with R and BR PDAC, performance status 0-1, and age 20-85 years. Hypofractionated external-beam radiotherapy (30 Gy in 10 fractions) with concurrent S-1 (60 mg/m(2)) was delivered 5 days/week for 2 weeks prior to pancreatectomy...
June 12, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28599404/neoadjuvant-chemotherapy-for-pancreatic-cancer-effects-on-cancer-tissue-and-novel-perspectives
#9
Hidehiro Tajima, Isamu Makino, Yoshinao Ohbatake, Shinichi Nakanuma, Hironori Hayashi, Hisatoshi Nakagawara, Tomoharu Miyashita, Hiroyuki Takamura, Tetsuo Ohta
Chemotherapy for pancreatic cancer has diversified following the addition of more treatment regimens; however, in spite of this, pancreatic cancer remains a fatal disease. Preoperative (neoadjuvant) chemotherapy (NAC) or neoadjuvant chemoradiation therapy (NACRT) has been developed and implemented. For patients with borderline resectable pancreatic cancer (BRPC) and locally advanced pancreatic cancer (LAPC), a number of clinical trials have been conducted; NACRT was demonstrated to improve resectability, R0 resection rate, overall survival rate, disease-free survival rate and even an LAPC and BRPC survival advantage over NAC...
June 2017: Oncology Letters
https://www.readbyqxmd.com/read/28597320/diagnostic-laparoscopy-prior-to-neoadjuvant-therapy-in-pancreatic-cancer-is-high-yield-an-analysis-of-outcomes-and-costs
#10
June S Peng, Jeffrey Mino, Rosebel Monteiro, Gareth Morris-Stiff, Noaman S Ali, Jane Wey, Kevin M El-Hayek, R Matthew Walsh, Sricharan Chalikonda
BACKGROUND: There is currently no standardized regimen for management of borderline resectable pancreatic cancer (BRPC), and treatment includes varying sequences of surgery, chemotherapy, and/or radiation. This study examines the diagnostic yield and cost of performing staging diagnostic laparoscopy (SDL) prior to neoadjuvant therapy (NAT) in BRPC. METHODS: Sequential patients treated for BRPC between January 2010 and October 2013 were included. SDL was adopted in a staged fashion due to surgeon preference, and included biopsy of visible lesions and washings for cytology...
June 8, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28588713/neoadjuvant-chemotherapy-in-borderline-resectable-pancreatic-cancer-a-case-report
#11
Maria Celeste Palmarocchi, Ruben Carlo Balzarotti Canger, Piercarlo Saletti
Pancreatic cancer is the fourth leading cause of cancer mortality and is associated with a poor overall survival even when diagnosed early and considered resectable. Complete surgical removal with negative histological margins is an independent predictor of survival and remains the only potential curative treatment. In borderline resectable pancreatic adenocarcinoma (BRPAC), preoperative systemic therapy may increase resectability and margin-negative resection rate. There is no current consensus on the optimal chemotherapy regimen for BRPAC...
June 2017: Oncology Letters
https://www.readbyqxmd.com/read/28567455/laparoscopic-total-pancreatectomy-for-multiple-metastasis-of-renal-cell-carcinoma-of-the-pancreas-a-case-report-and-literature-review
#12
Yun Jong Choi, Jin Ho Lee, Cho Rok Lee, Woong Kyu Han, Chang Moo Kang, Woo Jung Lee
Advances in surgical techniques and laparoscopic instruments have resulted in the development of laparoscopic pancreatic surgery. Total pancreaticoduodenectomy is performed for treating benign and borderline pancreatic disease involving the whole pancreas. Here, we report a case of metastatic renal cell carcinoma in the pancreas, treated by laparoscopic pylorus-preserving total pancreaticoduodenectomy. A 59-year-old woman was diagnosed with metastatic renal cell carcinoma. Multiple metastatic lesions were found on routine follow-up...
May 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28564637/efficacy-and-safety-of-neoadjuvant-folfirinox-for-borderline-resectable-pancreatic-adenocarcinoma-improved-efficacy-compared-with-gemcitabine-based-regimen
#13
Changhoon Yoo, Jihoon Kang, Kyu-Pyo Kim, Jae-Lyun Lee, Baek-Yeol Ryoo, Heung-Moon Chang, Sang Soo Lee, Do Hyun Park, Tae Jun Song, Dong Wan Seo, Sung Koo Lee, Myung-Hwan Kim, Jin-Hong Park, Dae Wook Hwang, Ki Byung Song, Jae Hoon Lee, Song Cheol Kim
Borderline resectable pancreatic cancer (BRPC) is a potentially resectable disease but is associated with poorer survival compared to primary resectable disease. There has been no prospective trial that compare the efficacy of FOLFIRNOX and gemcitabine-based regimen for BRPC. Between February 2013 and December 2014, 18 patients with BRPC receiving FOLFIRINOX were reviewed retrospectively. For comparative analysis, data for all BRPC patients (n=18) in our previous phase 2 study of neoadjuvant fixed-dose rate-gemcitabine plus capecitabine were pooled...
May 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28561672/pancreatic-adenocarcinoma-improving-prevention-and-survivorship
#14
Davendra P S Sohal, Field F Willingham, Massimo Falconi, Kara L Raphael, Stefano Crippa
Pancreatic cancer is a growing problem in oncology, given slowly rising incidence and continued suboptimal outcomes. A concerted effort to reverse this tide will require prevention, early diagnosis, and improved systemic therapy for curable disease. We focus on these aspects in detail in this study. Hereditary pancreatic cancer is an underappreciated area. With the growing use of genomics (both somatic and germline) in cancer care, there is increasing recognition of hereditary pancreatic cancer cases: around 10% of all pancreatic cancer may be related to familial syndromes, such as familial atypical multiple mole and melanoma (FAMMM) syndrome, hereditary breast and ovarian cancer, Lynch syndrome, and Peutz-Jeghers syndrome...
2017: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/28544758/neoadjuvant-therapy-in-pancreatic-cancer-a-systematic-review-and-meta-analysis-of-prospective-studies
#15
Han-Xiang Zhan, Jian-Wei Xu, Dong Wu, Zhi-Yang Wu, Lei Wang, San-Yuan Hu, Guang-Yong Zhang
There is a strong rationale and many theoretical advantages for neoadjuvant therapy in pancreatic cancer (PC). However, study results have varied significantly. In this study, a systematic review and meta-analysis of prospective studies were performed in order to evaluate safety and effectiveness of neoadjuvant therapy in PC. Thirty-nine studies were selected (n = 1458 patients), with 14 studies focusing on patients with resectable disease (group 1), and 19 studies focusing on patients with borderline resectable and locally advanced disease (group 2)...
June 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28541392/reply-to-borderline-resectable-pancreatic-cancer-an-evolving-concept
#16
J W Gilbert, B Wolpin, T Clancy, J Wang, H Mamon, A B Shinagare, J Jagannathan, M Rosenthal
No abstract text is available yet for this article.
May 25, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28525638/glucokinase-gene-may-be-a-more-suitable-target-than-the-insulin-gene-for-detection-of-beta-cell-death
#17
J Sklenarova, L Petruzelkova, S Kolouskova, J Lebl, Z Sumnik, O Cinek
Detection and quantification of unmethylated circulating insulin (INS) DNA presumably released from beta cells has been previously used for assessing their destruction. As the targets within the INS gene suffer from suboptimal specificity, we sought to improve the assay parameters by using the glucokinase gene (GCK) tissue-specific pancreatic promoter.The amount of methylated and unmethylated GCK DNA was measured using a droplet PCR assay, and compared with the previously published INS-targeted assay. The method was tested using synthetic target sequences and DNA from pancreatic islets, blood, brain, kidney, large intestine, liver, lung, small intestine and stomach...
May 18, 2017: Endocrinology
https://www.readbyqxmd.com/read/28523415/pictorial-review-of-vascular-involvement-and-complex-vascular-reconstructions-in-borderline-to-minimally-advanced-pancreatic-malignancies
#18
REVIEW
Donald L Ly, Seng Thipphavong, Boraiah Sreeharsha
PURPOSE: To review borderline resectability criteria for pancreatic malignancies, show examples of few surgically treated minimally advanced pancreatic malignancies, discuss various complex vascular reconstructions, and highlight the imaging appearances. BACKGROUND: Often aggressive surgical approaches are used to treat borderline to minimally advanced pancreatic malignancies in specialist centers. As abdominal radiologists it is essential to have up-to-date knowledge to distinguish such tumors with accuracy and also be well versed with the various vascular reconstructions used in such surgeries...
May 18, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28515255/active-systemic-treatment-of-pancreatic-cancer
#19
Margaret Tempero
By 2020, pancreatic cancer is expected to be the second most common cause of cancer-related death, exceeded only by lung cancer. During her presentation at the NCCN 22nd Annual Conference, Dr. Margaret Tempero offered an update on the current state of systemic treatment of pancreatic cancer, focusing on resectable/borderline resectable, locally advanced, and metastatic disease.
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28513899/surgical-strategies-and-novel-therapies-for-locally-advanced-pancreatic-cancer
#20
REVIEW
Jad Abou-Khalil, Flavio G Rocha
Many patients with pancreatic cancer are not candidates for surgical resection due to involvement of critical mesenteric vascular structures. We compare and contrast the commonly used classification systems for borderline resectable and locally advanced pancreatic cancer. We describe the current strategies in managing venous and arterial involvement, as well as the role of neoadjuvant chemotherapy and chemoradiation, before explanding on a novel clinical trial in this patient population.
May 17, 2017: Journal of Surgical Oncology
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