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Pancreatic borderline

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https://www.readbyqxmd.com/read/28525638/glucokinase-gene-may-be-a-more-suitable-target-than-the-insulin-gene-for-detection-of-beta-cell-death
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/28486290/-radiological-and-surgical-implications-of-neoadjuvant-treatment-with-folfirinox-for-locally-advanced-and-borderline-resectable-pancreatic-cancer
#5
Satyajit Ashok Godhi, Kunal Parasar, Sundeep Saluja, Pramod Mishra
No abstract text is available yet for this article.
June 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28482348/prolonged-neoadjuvant-therapy-for-locally-advanced-pancreatic-cancer
#6
Hidetoshi Eguchi, Daisaku Yamada, Yoshifumi Iwagami, Kunihito Gotoh, Koichi Kawamoto, Hiroshi Wada, Tadafumi Asaoka, Takehiro Noda, Yutaka Takeda, Masahiro Tanemura, Daisuke Sakai, Taroh Satoh, Toshihiro Kudo, Fumiaki Isohashi, Masaki Mori, Yuichiro Doki
PURPOSE: The purpose of this study was to investigate if prolonged neoadjuvant therapy, for locally advanced pancreatic cancer could be used to identify those patients who could benefit from resection surgery. METHODS: Thirty-four patients with locally advanced pancreatic cancer invading the adjacent major arteries underwent chemoradiotherapy, followed by 6 months of systemic chemotherapy, unless their tumor was already resectable. After this combination treatment, surgical resection was performed on those patients with tumors judged to be at least borderline resectable...
May 9, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28468714/the-indications-for-laparoscopic-pancreatectomy
#7
Marco Siech, Peter Strauss, Stephanie Huschitt, Detlef K Bartsch, Uwe Wittel, Tobias Keck
BACKGROUND: Laparoscopic pancreatectomy is not yet established as a routine procedure everywhere in Germany or in other countries. Few data are available on its short- and long-term outcomes. METHODS: From 2008 onward, a working group initiated by 10 centers and currently comprising 34 centers has gathered data on all cases of laparoscopic pancreatectomy. Procedures in which laparoscopy was converted to open surgery are also included. RESULTS: The registry now contains 550 data sets representing 267 cases of benign disease, 244 malignancies, and 39 borderline tumors...
April 14, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28460245/3rd-st-gallen-eortc-gastrointestinal-cancer-conference-consensus-recommendations-on-controversial-issues-in-the-primary-treatment-of-pancreatic-cancer
#8
REVIEW
Manfred P Lutz, John R Zalcberg, Michel Ducreux, Daniela Aust, Marco J Bruno, Markus W Büchler, Jean-Robert Delpero, Beat Gloor, Rob Glynne-Jones, Werner Hartwig, Florence Huguet, Pierre Laurent-Puig, Florian Lordick, Patrick Maisonneuve, Julia Mayerle, Marc Martignoni, John Neoptolemos, Andrew D Rhim, Bruno M Schmied, Thomas Seufferlein, Jens Werner, Jean-Luc van Laethem, Florian Otto
The primary treatment of pancreatic cancer was the topic of the 3rd St. Gallen Conference 2016. A multidisciplinary panel reviewed the current evidence and discussed controversial issues in a moderated consensus session. Here we report on the key expert recommendations. It was generally accepted that radical surgical resection followed by adjuvant chemotherapy offers the only evidence-based treatment with a chance for cure. Initial staging should classify localised tumours as resectable or unresectable (i.e...
April 28, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28449702/quantification-of-renal-function-following-stereotactic-body-radiotherapy-for-pancreatic-cancer-secondary-dosimetric-analysis-of-a-prospective-clinical-trial
#9
Vivek Verma, Abhijeet R Bhirud, Kyle A Denniston, Nathan R Bennion, Chi Lin
BACKGROUND: This is the first known study examining renal function following stereotactic body radiotherapy (SBRT) for pancreatic head adenocarcinoma. METHODS: Thirty-eight borderline-resectable/unresectable patients, part of an ongoing prospective trial, underwent 3 cycles of gemcitabine/5-fluorouracil followed by SBRT (5 daily fractions of 5/6/7/8 Gy) and concurrent nelfinavir. Thereafter, in resectable cases, surgery was performed within 4-8 weeks. The last available pre-SBRT creatinine was recorded, along with the highest post-SBRT value...
April 27, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28445400/targeting-the-epidermal-growth-factor-receptor-in-addition-to-chemotherapy-in-patients-with-advanced-pancreatic-cancer-a-systematic-review-and-meta-analysis
#10
REVIEW
Jaseela Chiramel, Alison C Backen, Rille Pihlak, Angela Lamarca, Melissa Frizziero, Noor-Ul-Ain Tariq, Richard A Hubner, Juan W Valle, Eitan Amir, Mairéad G McNamara
Overexpression of epidermal growth factor receptors (EGFR) occurs in >90% of pancreatic ductal adenocarcinomas (PDACs) and is associated with a poorer prognosis. A systematic review of electronic databases identified studies exploring the addition of EGFR-targeted treatment to chemotherapy in patients with locally advanced (LA)/metastatic PDAC. Efficacy, safety and tolerability of EGFR-targeted therapy were explored using meta-analysis of randomised controlled trials (RCTs). Meta-regression was utilised to explore factors associated with improved prognosis (all studies) and benefit from EGFR-targeted therapy (RCTs)...
April 26, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28440538/massive-nasal-polyposis-in-a-patient-with-newly-diagnosed-cystic-fibrosis
#11
Małgorzata Olszowiec-Chlebna, Krzysztof Trzciński, Iwona Stelmach
INTRODUCTION: Cystic fibrosis (CF) - is the most common fatal autosomal recessive disease in Caucasians. A number of reports have described patients who do not meet diagnostic criteria for cystic fibrosis. Atypical or nonclassic CF is characterised by normal or borderline sweat test, pancreatic sufficiency and a monosymptomatic phenotype. For these reasons clinicians should remain alert to the possibility of the occurrence of CF. CASE REPORT: We described a case presentation of massive nasal polyposis and recurrent sinusitis leading to the diagnosis ofcystic fibrosis in a 11-year-old male...
2017: Advances in Respiratory Medicine
https://www.readbyqxmd.com/read/28427822/reassessment-of-the-clinical-significance-of-portal-superior-mesenteric-vein-invasion-in-borderline-resectable-pancreatic-cancer
#12
S Hoshimoto, S Hishinuma, H Shirakawa, M Tomikawa, I Ozawa, S Wakamatsu, S Hoshi, N Hoshi, K Hirabayashi, Y Ogata
OBJECTIVE: The principal objective of this study is to clarify the prognostic significance of borderline resectable pancreatic cancer (BRPC). The second objective is to evaluate the prognostic impact of the depth of pathological venous invasion. METHODS: The study included 122 pancreatic cancer patients who underwent curative surgery. All computed tomography scans of the patients were retrospectively interpreted and classified according to the NCCN guidelines, version 1...
April 8, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28424909/comparison-of-clinical-outcomes-and-quality-of-life-between-laparoscopic-and-open-central-pancreatectomy-with-pancreaticojejunostomy
#13
Ren-Chao Zhang, Bin Zhang, Yi-Ping Mou, Xiao-Wu Xu, Yu-Cheng Zhou, Chao-Jie Huang, Jia-Yu Zhou, Wei-Wei Jin, Chao Lu
BACKGROUND: The studies comparing laparoscopic and open central pancreatectomy with pancreaticojejunostomy are limited. This study aimed to compare clinical outcomes and quality of life of patients undergoing laparoscopic and open central pancreatectomy with pancreaticojejunostomy. METHODS: Between December 1997 and December 2015, patients who underwent central pancreatectomy with pancreaticojejunostomy were reviewed. Patients were divided into 2 groups as laparoscopic central pancreatectomy (LCP) and open central pancreatectomy (OCP)...
April 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28407088/borderline-resectable-pancreatic-cancer-conceptual-evolution-and-current-approach-to-image-based-classification
#14
J W Gilbert, B Wolpin, T Clancy, J Wang, H Mamon, A B Shinagare, J Jagannathan, M Rosenthal
BACKGROUND: Diagnostic imaging plays a critical role in the initial diagnosis and therapeutic monitoring of pancreatic adenocarcinoma. Over the past decade, the concept of "borderline resectable" pancreatic cancer has emerged to describe a distinct subset of patients existing along the spectrum from resectable to locally advanced disease for whom a microscopically margin-positive (R1) resection is considered relatively more likely, primarily due to the relationship of the primary tumor with surrounding vasculature...
April 12, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28391577/neoadjuvant-treatment-in-pancreatic-cancer-evidence-based-medicine-a-systematic-review-and-meta-analysis
#15
REVIEW
Francesco D'Angelo, Laura Antolino, Alessio Farcomeni, Dario Sirimarco, Andrea Kazemi Nava, Martina De Siena, Niccolò Petrucciani, Giuseppe Nigri, Stefano Valabrega, Paolo Aurello, Giovanni Ramacciato
Neoadjuvant treatment in non-metastatic pancreatic cancer (PaC) has the theoretical advantages of downstaging the tumor, sterilizing any present systemic undetectable disease, selecting patients for surgery and administering therapy to each patient. The aim of this systematic review is to analyze the state of the art on neoadjuvant protocols for non-metastatic PaC. A literature search over the last 10 years was conducted, and papers had to be focused on resectable, borderline resectable (BLR) or locally advanced (LA) histo- or cytologically proven PaC; to be prospective studies or prospectively collected databases; to report percentage of protocol achievement and survival data at least in an intention-to-treat (ITT) analysis...
May 2017: Medical Oncology
https://www.readbyqxmd.com/read/28389044/fdg-pet-predicts-treatment-efficacy-and-surgical-outcome-of-pre-operative-chemoradiation-therapy-for-resectable-and-borderline-resectable-pancreatic-cancer
#16
H Akita, H Takahashi, H Ohigashi, A Tomokuni, S Kobayashi, K Sugimura, N Miyoshi, J-H Moon, M Yasui, T Omori, H Miyata, M Ohue, Y Fujiwara, M Yano, O Ishikawa, M Sakon
BACKGROUND: The efficacy of neoadjuvant chemoradiotherapy (NACRT) for resectable and borderline resectable pancreatic cancer is important for predicting outcomes after radical surgery, but few clinical indicators predict outcome before resection. This study examined the utility of FDG-PET in predicting the efficacy of NACRT and outcome after radical surgery. METHODS: Eighty-three pancreatic cancer patients who underwent FDG-PET before and after NACRT and had positive standard uptake values (SUVs) before NACRT were enrolled in this study...
March 31, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28385584/a-study-of-the-clinical-utility-of-a-20-minute-secretin-stimulated-endoscopic-pancreas-function-test-and-performance-according-to-clinical-variables
#17
Luis F Lara, Morihito Takita, James S Burdick, Daniel C DeMarco, Ronnie R Pimentel, Tolga Erim, Marlon F Levy
BACKGROUND AND AIMS: Direct pancreas juice testing of bicarbonate, lipase, or trypsin after stimulation by secretin or cholecystokinin is used to determine exocrine function, a surrogate for diagnosing chronic pancreatitis (CP). Endoscopic pancreas function tests (ePFTs), where a peak bicarbonate concentration (PBC) ≥80 mEq/L in pancreas juice is considered normal, are now used more frequently. In this ePFT, aspirates start 35 minutes after secretin administration because pancreas output peaks 30 minutes after secretagogue administration...
April 3, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28381388/pancreaticoduodenectomy-for-borderline-resectable-pancreatic-head-cancer-with-a-modified-artery-first-approach-technique
#18
Min Wang, Hang Zhang, Feng Zhu, Feng Peng, Xin Wang, Ming Shen, Ren-Yi Qin
BACKGROUND: The treatment of borderline resectable pancreatic head cancer (BRPHC) is still controversial and challenging. The artery-first approaches are described to be the important options for the early determination. Whether these approaches can achieve an increase R0 rate, better bleeding control and increasing long-term survival for BRPHC are still controversial. We compared a previously reported technique, a modified artery-first approach (MAFA), with conventional techniques for the surgical treatment of BRPHC...
April 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28378800/phase-ii-study-of-induction-chemotherapy-followed-by-chemoradiotherapy-in-patients-with-borderline-resectable-and-unresectable-locally-advanced-pancreatic-cancer
#19
Michele Fiore, Sara Ramella, Sergio Valeri, Damiano Caputo, Barnaba Floreno, Pasquale Trecca, Luca Eolo Trodella, Lucio Trodella, Rolando Maria D'Angelillo, Roberto Coppola
There is not a clear consensus regarding the optimal treatment of locally advanced pancreatic disease. There is a potential role for neoadjuvant therapy to treat micrometastatic disease with chemotherapy, as well as for the treatment of local disease with radiotherapy. We evaluated the safety and efficacy of induction chemotherapy with oxaliplatin and gemcitabine followed by a high weekly dose of gemcitabine concurrent to radiation therapy in patients with borderline resectable and unresectable locally advanced pancreatic cancer...
April 5, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28378027/a-phase-ii-trial-of-neoadjuvant-chemoradiotherapy-with-intensity-modulated-radiotherapy-combined-with-gemcitabine-and-s-1-for-borderline-resectable-pancreatic-cancer-with-arterial-involvement
#20
Yuichi Nagakawa, Yuichi Hosokawa, Hidetsugu Nakayama, Yatsuka Sahara, Chie Takishita, Tetsushi Nakajima, Yousuke Hijikata, Kazuhiko Kasuya, Kenji Katsumata, Koichi Tokuuye, Akihiko Tsuchida
PURPOSE: Chemoradiotherapy using intensity-modulated radiotherapy (IMRT) is expected to provide a powerful alternative to conventional chemotherapy with a low incidence of adverse events. This study evaluated the efficacy of intensity modulated radiotherapy in combination with gemcitabine and S-1 as neoadjuvant chemoradiotherapy (NACRT) for borderline-resectable pancreatic cancer with arterial involvement (BR-A). METHODS: A total of 27 patients with BR-A were enrolled in this study between February 2012 and September 2015...
April 4, 2017: Cancer Chemotherapy and Pharmacology
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