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Pancreatic borderline

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https://www.readbyqxmd.com/read/29139084/common-hepatic-artery-abutment-or-encasement-is-an-adverse-prognostic-factor-in-patients-with-borderline-and-unresectable-pancreatic-cancer
#1
Geoffrey M Kozak, Jeffrey D Epstein, Sandeep P Deshmukh, Benjamin B Scott, Scott W Keith, Harish Lavu, Charles J Yeo, Jordan M Winter
BACKGROUND: Localized and unresectable pancreatic ductal adenocarcinoma (PDA) comprises one third of new diagnoses and includes borderline resectable (BR) and locally advanced (LA) unresectable disease. In a cohort of patients who were treated and followed at a single institution, we assessed clinical and radiographic predictors of outcome. METHODS: The study included 69 consecutive patients with BR or LA PDA. Serial imaging studies were reviewed by both a pancreatic surgeon and a radiologist for vascular abutment or encasement by cancer, and they were recorded...
November 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29137016/binding-pancreaticogastrostomy-anastomosis-in-central-pancreatectomy-a-single-center-experience
#2
Pengcheng Kang, Zhidong Wang, Kaiming Leng, Xiangyu Zhong, Hao Wang, Ming Wan, Sheng Tai, Yunfu Cui
A growing number of central pancreatectomies are performed. However, reconstruction of pancreaticoenteral digestive continuity after central pancreatectomy remains debated. This study evaluates the short-term outcomes of binding pancreaticogastrostomy anastomosis in central pancreatectomy.We have reviewed our experience with 52 patients who underwent binding pancreaticogastrostomy following central pancreatectomy from February 2009 to March 2015. Indication includes 6 noninvasive intraductal papillary mucinous neoplasms, 11 neuroendocrine tumors, 12 solid pseudopapillary tumor, 9 serous cystadenoma, 6 mucinous cystadenoma, and 8 focal pancreatic traumas...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29113659/a-comparative-study-of-neoadjuvant-treatment-with-gemcitabine-plus-nab-paclitaxel-versus-surgery-first-for-pancreatic-adenocarcinoma
#3
Benedetto Ielpo, Riccardo Caruso, Hipolito Duran, Eduardo Diaz, Isabel Fabra, Luis Malavé, Valentina Ferri, Rafael Alvarez, Antonio Cubillo, Carlos Plaza, Sara Lazzaro, Denis Kalivaci, Yolanda Quijano, Emilio Vicente
INTRODUCTION: Neoadjuvant treatment has been reported to prolong survival in patients with potentially resectable pancreatic adenocarcinoma (PA). However, there are currently limited clinical results available using nab-paclitaxel and gemcitabine in PA. This paper compares the oncological results of patients affected by potentially resectable PA who underwent surgery first (SF) versus surgery following neoadjuvant treatment (NAT). METHODS: This is an observational, comparative study whereby data were abstracted from a prospective database of patients affected by PA from 2007 to 2016...
December 2017: Surgical Oncology
https://www.readbyqxmd.com/read/29097875/trends-and-outcomes-of-pancreaticoduodenectomy-for-periampullary-tumors-a-25-year-single-center-study-of-1000-consecutive-cases
#4
Ayman El Nakeeb, Waleed Askar, Ehab Atef, Ehab El Hanafy, Ahmad M Sultan, Tarek Salah, Ahmed Shehta, Mohamed El Sorogy, Emad Hamdy, Mohamed El Hemly, Ahmed A El-Geidi, Tharwat Kandil, Mohamed El Shobari, Talaat Abd Allah, Amgad Fouad, Mostafa Abu Zeid, Ahmed Abu El Eneen, Nabil Gad El-Hak, Gamal El Ebidy, Omar Fathy, Ahmed Sultan, Mohamed Abdel Wahab
AIM: To evaluate the evolution, trends in surgical approaches and reconstruction techniques, and important lessons learned from performing 1000 consecutive pancreaticoduodenectomies (PDs) for periampullary tumors. METHODS: This is a retrospective review of the data of all patients who underwent PD for periampullary tumor during the period from January 1993 to April 2017. The data were categorized into three periods, including early period (1993-2002), middle period (2003-2012), and late period (2013-2017)...
October 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29094173/imaging-of-post-operative-pancreas-and-complications-after-pancreatic-adenocarcinoma-resection
#5
Nima Hafezi-Nejad, Elliot K Fishman, Atif Zaheer
Pancreatic ductal adenocarcinoma is one of the leading causes of cancer-related deaths. With surgical resection being the only definitive treatment, improvements in technique has led to an increase in number of candidates undergoing resection by inclusion of borderline resectable disease patients to the clearly resectable group. Post-operative complications associated with pancreaticoduodenectomy and distal pancreatectomy include delayed gastric emptying, anastomotic failures, fistula formation, strictures, abscess, infarction, etc...
November 1, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29094028/survival-outcome-and-prognostic-factors-of-neoadjuvant-treatment-followed-by-resection-for-borderline-resectable-pancreatic-cancer
#6
Hyeong Seok Kim, Jin-Young Jang, Youngmin Han, Kyoung Bun Lee, Ijin Joo, Doo-Ho Lee, Jae Ri Kim, Hongbeom Kim, Wooil Kwon, Sun-Whe Kim
Purpose: Neoadjuvant treatment may provide improved survival outcomes for patients with borderline resectable pancreatic cancer (BRPC). The purpose of this study is to evaluate the clinical outcomes of neoadjuvant treatment and to identify prognostic factors. Methods: Forty patients who met the National Comprehensive Cancer Network definition of BRPC and received neoadjuvant treatment followed by surgery between 2007 and 2015 were evaluated. Prospectively collected clinicopathological outcomes were analyzed retrospectively...
October 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29073149/intrapancreatic-injection-of-human-bone-marrow-derived-mesenchymal-stem-stromal-cells-alleviates-hyperglycemia-and-modulates-the-macrophage-state-in-streptozotocin-induced-type-1-diabetic-mice
#7
Norimitsu Murai, Hirokazu Ohtaki, Jun Watanabe, Zhifang Xu, Shun Sasaki, Kazumichi Yagura, Seiji Shioda, Shoichiro Nagasaka, Kazuho Honda, Masahiko Izumizaki
Type 1 diabetes mellitus is a progressive disease caused by the destruction of pancreatic β-cells, resulting in insulin dependency and hyperglycemia. While transplanted bone marrow-derived mesenchymal stem/stromal cells (BMMSCs) have been explored as an alternative therapeutic approach for diseases, the choice of delivery route may be a critical factor determining their sustainability. This study evaluated the effects of intrapancreatic and intravenous injection of human BMMSCs (hBMMSCs) in streptozotocin (STZ)-induced type 1 diabetic mouse model...
2017: PloS One
https://www.readbyqxmd.com/read/29061632/neoadjuvant-s-1-with-concurrent-radiotherapy-followed-by-surgery-for-borderline-resectable-pancreatic-cancer-study-protocol-for-an-open-label-multicentre-prospective-phase-ii-trial-jaspac05
#8
Shinichiro Takahashi, Izumi Ohno, Masafumi Ikeda, Tatsushi Kobayashi, Tetsuo Akimoto, Motohiro Kojima, Masaru Konishi, Katsuhiko Uesaka
INTRODUCTION: Borderline resectable pancreatic cancer (BRPC) can involve the portal vein, superior mesenteric vein, superior mesenteric artery, coeliac axis or hepatic artery, and has a high probability of positive surgical margins and poor prognosis after resection. Neoadjuvant chemoradiation is expected to provide substantial local control and prolong survival in patients with BRPC. METHODS AND ANALYSIS: This open-label, multicentre, prospective phase II trial will assess S-1 with concurrent radiotherapy as preoperative treatment for BRPC...
October 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/29036034/investigation-of-association-between-borderline-pancreatic-head-cancer-and-glucose-uptake-by-using-positron-emission-tomographic-studies
#9
Ying Zhang, Lei Qin, Changming Zhang
BACKGROUND In the background of the well-known importance of positron-emission tomographic studies (PET) in the prediction of pancreatic oncologic problems, we designed and performed this investigation to study the link between borderline pancreatic head cancer and glucose uptake by using PET. MATERIAL AND METHODS We retrospectively investigated patients during the period of almost 4 years (May 2013 to December 2016). Patients underwent potentially curative resection for borderline exocrine pancreatic head adenocarcinoma without undergoing neoadjuvant therapy...
October 16, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29017581/neoadjuvant-treatment-of-pancreatic-adenocarcinoma-a-systematic-review-and-meta-analysis-of-5520-patients
#10
Mashaal Dhir, Gautam K Malhotra, Davendra P S Sohal, Nicholas A Hein, Lynette M Smith, Eileen M O'Reilly, Nathan Bahary, Chandrakanth Are
BACKGROUND: Recent years have seen standardization of the anatomic definitions of pancreatic adenocarcinoma, and increasing utilization of neoadjuvant therapy (NAT). The aim of the current review was to summarize the evidence for NAT in pancreatic adenocarcinoma since 2009, when consensus criteria for resectable (R), borderline resectable (BR), and locally advanced (LA) disease were endorsed. METHODS: PubMed search was undertaken along with extensive backward search of the references of published articles to identify studies utilizing NAT for pancreatic adenocarcinoma...
October 10, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28992935/initial-experience-in-the-treatment-of-borderline-resectable-pancreatic-adenocarcinoma
#11
Juli Busquets, Juan Fabregat, Helena Verdaguer, Berta Laquente, Núria Pelaez, Luis Secanella, David Leiva, Teresa Serrano, María Cambray, Rafael Lopez-Urdiales, Emilio Ramos
INTRODUCTION: A borderline resectable group (APBR) has recently been defined in adenocarcinoma of the pancreas. The objective of the study is to evaluate the results in the surgical treatment after neoadjuvancy of the APBR. METHOD: Between 2010 and 2014, we included patients with APBR in a neoadjuvant and surgery protocol, staged by multidetector computed tomography (MDCT). Treatment with chemotherapy was based on gemcitabine and oxaliplatin. Subsequently, MDCT was performed to rule out progression, and 5-FU infusion and concomitant radiotherapy were given...
October 2017: Cirugía Española
https://www.readbyqxmd.com/read/28975822/multimodality-management-of-borderline-resectable-pancreatic-neuroendocrine-tumors-report-of-a-single-institution-experience
#12
Chenwi M Ambe, Phuong Nguyen, Barbara A Centeno, Junsung Choi, Jonathan Strosberg, Larry Kvols, Pamela Hodul, Sarah Hoffe, Mokenge P Malafa
BACKGROUND: Pancreatic neuroendocrine tumors (PanNETs) constitute approximately 3% of pancreatic neoplasms. Like patients with pancreatic ductal adenocarcinoma (PDAC), some of these patients present with "borderline resectable disease." For these patients, an optimal treatment approach is lacking. We report our institution's experience with borderline resectable PanNETs using multimodality treatment. METHODS: We identified patients with borderline resectable PanNETs who had received neoadjuvant therapy at our institution between 2000 and 2013...
October 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28968257/clinical-characteristics-of-patients-experiencing-pathologic-complete-response-following-neoadjuvant-therapy-for-borderline-resectable-locally-advanced-pancreatic-adenocarcinoma
#13
Neda Hashemi-Sadraei, Olumide B Gbolahan, Hai Salfity, Bert O'Neil, Michael G House, Safi Shahda
OBJECTIVES: The purpose of this study is to describe clinical characteristics and outcomes of patients with borderline resectable pancreatic cancer (BRPC) or locally advanced pancreatic cancer (LAPC) who achieved pathologic complete response (pCR) following neoadjuvant therapy. MATERIALS AND METHODS: A single institution clinical database for patients with pancreatic ductal adenocarcinoma was queried. Between 2008 and 2014 patients were identified with BRPC and LAPC, who underwent surgical resection after receiving neoadjuvant treatment...
September 29, 2017: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28953554/prognostic-value-of-resection-margin-involvement-after-pancreaticoduodenectomy-for-ductal-adenocarcinoma-updates-from-a-french-prospective-multicenter-study
#14
MULTICENTER STUDY
Jean Robert Delpero, Florence Jeune, Philippe Bachellier, Nicolas Regenet, Yves Patrice Le Treut, Francois Paye, Nicolas Carrere, Alain Sauvanet, Mustapha Adham, Aurelie Autret, Flora Poizat, Olivier Turrini, Jean Marie Boher
OBJECTIVE: The aim of the study was to assess the relevance of resection margin status for survival after resection of pancreatic-head ductal adenocarcinoma. SUMMARY BACKGROUND DATA: The definition and prognostic value of incomplete microscopic resection (R1) remain controversial. METHODS: Prognostic factors were analyzed in 147 patients included in a prospective multicenter study on the impact of tumor clearance evaluated using a standardized pathology protocol...
November 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28948329/surgery-for-pancreatic-cancer-critical-radiologic-findings-for-clinical-decision-making
#15
Annabelle L Fonseca, Jason B Fleming
Pancreatic cancer is the fourth leading cause of cancer-related deaths in the United States, with an estimated 53,670 new cases diagnosed and an estimated 43,090 deaths in 2017. This high mortality rate is in part due to the small percentage of patients diagnosed with local disease, as well as the biologically aggressive nature of the disease. While only 10-20% of patients will present with surgically resectable disease, this is the only possible curative therapy. Five-year survival of resected pancreatic cancer ranges from 12 to 27%...
September 25, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28945895/selecting-patients-for-resection-after-primary-chemotherapy-for-non-metastatic-pancreatic-adenocarcinoma
#16
M Reni, S Zanon, G Balzano, S Nobile, C C Pircher, M Chiaravalli, P Passoni, P G Arcidiacono, R Nicoletti, S Crippa, N Slim, C Doglioni, M Falconi, L Gianni
Background: Patients with borderline (BL) or locally advanced (LA) pancreatic adenocarcinoma are usually treated with primary chemotherapy (CT), followed by resection when feasible. Scanty data are available about the criteria to candidate patients to resection after CT. Patients and methods: Between 2002 and 2016 overall 223 patients diagnosed with BL or LA pancreatic adenocarcinoma were primarily treated with Gemcitabine combination (4-drugs or nab-paclitaxel-gemcitabine) for 3-6 months followed by surgery and/or chemoradiation...
November 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28925490/multi-detector-spiral-ct-diagnosis-of-common-bile-duct-ampullary-carcinoma
#17
D-Z Zhao, Y Guo, Y-P Sun, H-M Liu, Z Zhang, Q-L Ma, Y-S Wang, C-L Chen
OBJECTIVE: The aim of this project was to study the imaging characteristics of multi-detector CT (MDCT) in different types of malignant tumor in the common bile duct ampulla. PATIENTS AND METHODS: We examined 30 cases of pancreatic head cancer, 35 of terminal cholangiocarcinoma, 26 of ampullary carcinoma, and 40 of benign lesions, all confirmed by pathology. We used 64-slice spiral CT plain scan and multi-phase enhanced scan with multi-planar reconstruction (MPR) and curved planar reconstruction (CPR) post-processing to obtain three-dimensional images...
August 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28923230/randomized-clinical-trials-in-pancreatic-cancer
#18
REVIEW
Neha Goel, Sanjay S Reddy
The management of pancreatic cancer has grown rapidly in the last decade. The Gastrointestinal Tumor Study Group trial in 1985 supported postoperative chemoradiation, and a more recent study recommended 6 months of adjuvant gemcitabine and capecitabine or monotherapy with gemcitabine or fluorouracil plus folinic acid, in the absence of neoadjuvant therapy. Clinicians are now studying the role of targeted therapy in pancreatic cancer and neoadjuvant chemotherapy in resectable, borderline resectable, and locally advanced pancreatic cancer...
October 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28911082/borderline-resectable-pancreatic-cancer-an-evolving-concept
#19
N Petrucciani, T Debs, G Nigri, F D'Angelo, J Gugenheim, G Ramacciato
No abstract text is available yet for this article.
September 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28886941/should-functional-renal-scans-be-obtained-prior-to-upper-abdominal-imrt-for-pancreatic-cancer
#20
Grace C Blitzer, William A Hall, Susan Tsai, Mohammed Aldakkak, Robert S Hellman, Douglas B Evans, Kathleen K Christians, Ben George, Paul S Ritch, Beth A Erickson
BACKGROUND: Upper abdominal irradiation for pancreatic cancer is administered in close proximity to the radiation-sensitive kidneys. There is difficulty in defining dose-volume parameters to predict late renal toxicity after partial kidney irradiation. Less than 10% of the general population is estimated to have asymmetrical kidney function; however, there are no studies that examine this in patients with pancreatic cancer. The primary purpose of this study was to determine the prevalence of asymmetrical kidney function in patients with pancreatic cancer...
June 29, 2017: Practical Radiation Oncology
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