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Pancreatic borderline

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https://www.readbyqxmd.com/read/28427822/reassessment-of-the-clinical-significance-of-portal-superior-mesenteric-vein-invasion-in-borderline-resectable-pancreatic-cancer
#1
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
#2
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
#3
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
#4
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
#5
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
#6
Luis F Lara, Morihito Takita, James S Burdick, Daniel C DeMarco, Ronnie R Pimentel, Tolga Erim, Marlon F Levy
BACKGROUND & AIMS: Direct pancreas juice testing of bicarbonate, lipase, or trypsin after stimulation by secretin or cholecystokinin (CCK) is used to determine exocrine function, a surrogate for diagnosing chronic pancreatitis (CP). Endoscopic pancreas function tests (ePFT) 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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28342938/the-impact-of-neoadjuvant-therapy-on-the-histopathological-features-of-pancreatic-ductal-adenocarcinoma-a-systematic-review-and-meta-analysis
#10
REVIEW
Stephan Schorn, Ihsan Ekin Demir, Carmen Mota Reyes, Cemil Saricaoglu, Nicole Samm, Rebekka Schirren, Elke Tieftrunk, Daniel Hartmann, Helmut Friess, Güralp Onur Ceyhan
BACKGROUND: Due to increased rates of curative tumor resections exceeding 60% after FOLFIRINOX-treatment, neoadjuvant therapy/NTx is increasingly recognized as an effective therapy option for downstaging borderline or locally advanced pancreatic ductal adenocarcinoma/PDAC. Yet, the effects of NTx on the common histopathological features of PDAC have not been systematically analysed. Therefore, the aim of the current study was to assess the impact of NTx on relevant histopathological features of PDAC...
March 14, 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28335780/considerable-interobserver-variation-in-delineation-of-pancreatic-cancer-on-3dct-and-4dct-a-multi-institutional-study
#11
Eva Versteijne, Oliver J Gurney-Champion, Astrid van der Horst, Eelco Lens, M Willemijn Kolff, Jeroen Buijsen, Gati Ebrahimi, Karen J Neelis, Coen R N Rasch, Jaap Stoker, Marcel van Herk, Arjan Bel, Geertjan van Tienhoven
BACKGROUND: The delineation of pancreatic tumors on CT is challenging. In this study, we quantified the interobserver variation for pancreatic tumor delineation on 3DCT as well as on 4DCT. METHODS: Eight observers (radiation oncologists) from six institutions delineated pancreatic tumors of four patients with (borderline) resectable pancreatic cancer. The study consisted of two stages. In the 3DCT-stage, the gross tumor volume (GTV) was delineated on a contrast-enhanced scan...
March 23, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28314992/prognostic-impact-of-normalization-of-serum-tumor-markers-following-neoadjuvant-chemotherapy-in-patients-with-borderline-resectable-pancreatic-carcinoma-with-arterial-contact
#12
Yoshiaki Murakami, Kenichiro Uemura, Takeshi Sudo, Yasushi Hashimoto, Naru Kondo, Naoya Nakagawa, Kenjiro Okada, Shinya Takahashi, Taijiro Sueda
PURPOSE: The survival benefit of neoadjuvant therapy for patients with borderline resectable pancreatic carcinoma has been reported recently. However, prognostic factors for this strategy have not been clearly elucidated. The aim of this study was to clarify prognostic factors for patients with borderline resectable pancreatic carcinoma who received neoadjuvant chemotherapy. METHODS: Medical records of 66 patients with pancreatic carcinoma with arterial contact who intended to undergo tumor resection following neoadjuvant chemotherapy were analyzed retrospectively...
March 17, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28293715/a-phase-1-study-of-gemcitabine-nab-paclitaxel-s-1-gas-combination-neoadjuvant-chemotherapy-for-patients-with-locally-advanced-pancreatic-adenocarcinoma
#13
Naru Kondo, Yoshiaki Murakami, Kenichiro Uemura, Takeshi Sudo, Yasushi Hashimoto, Naoya Nakagawa, Shinya Takahashi, Hiroki Ohge, Taijiro Sueda
PURPOSE: To determine a recommended dose for a biweekly combination neoadjuvant chemotherapy including gemcitabine, nab-paclitaxel, and S-1 (GAS) for patients with locally advanced pancreatic ductal adenocarcinoma (LAPC). METHODS: Patients with borderline resectable or unresectable LAPC without distant metastasis were eligible for this study. The planned dosages of gemcitabine (mg/m(2), day 1), nab-paclitaxel (mg/m(2), day 1), and S-1 (mg/day, days 1-7) were 800/100/60-100 at level 1, and 1000/125/60-100 at level 2...
March 14, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28280624/the-concept-of-borderline-resectable-pancreatic-cancer-limited-foundations-and-limited-future
#14
John A Windsor, Savio George Barreto
Pancreatic ductal adenocarcinoma (PDAC) is traditionally treated by a surgery-first approach. The development and adoption of the concept of borderline resectable PDAC, which extends the role of surgery, is based on the proposition that neoadjuvant therapy (NAT) will increase the resection rate, margin negative rate and overall survival. There are a number of issues with this concept and a critical review of these suggests that it is based on limited foundations and likely has a limited future.
February 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28256908/assessment-with-cone-beam-computed-tomography-of-intrafractional-motion-and-interfractional-position-changes-of-resectable-and-borderline-resectable-pancreatic-tumours-with-implanted-fiducial-marker
#15
Shingo Ohira, Masaru Isono, Yoshihiro Ueda, Takero Hirata, Reiko Ashida, Hidenori Takahashi, Masayoshi Miyazaki, Masaaki Takashina, Masahiko Koizumi, Teruki Teshima
OBJECTIVE: The volume of targets to which a high radiation dose can be delivered is limited for pancreatic radiotherapy. We assessed changes in movements of pancreatic tumours between simulation and treatment and determined compensatory margins. METHODS: For 23 patients, differences in implanted fiducial marker motion magnitude (MMM) and mean marker position (MMP) between four-dimensional CT and cone-beam CT were measured. Subsequently, residual uncertainty was simulated after no action level (NAL) and extended no action level (eNAL) protocols were adopted...
April 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28247128/the-self-care-practices-of-family-caregivers-of-persons-with-poor-prognosis-cancer-differences-by-varying-levels-of-caregiver-well-being-and-preparedness
#16
J Nicholas Dionne-Odom, Wendy Demark-Wahnefried, Richard A Taylor, Gabrielle B Rocque, Andres Azuero, Aras Acemgil, Michelle Y Martin, Meka Astin, Deborah Ejem, Elizabeth Kvale, Karen Heaton, Maria Pisu, Edward E Partridge, Marie A Bakitas
PURPOSE: Little is known about the impact of family caregiving for adults with poor prognosis cancer on caregivers' own individual self-care practices. We explored differences in caregivers' discrete self-care practices associated with varying levels of caregiver well-being, preparedness, and decision-making self-efficacy. METHODS: Cross-sectional survey within eight community-based southeastern U.S. cancer centers was conducted. Family caregivers of Medicare beneficiaries ≥65 years with pancreatic, lung, brain, ovarian, head and neck, hematologic, or stage IV cancer completed measures of individual self-care practices (health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, stress management, and sleep), well-being (anxiety, depression, and health-related quality of life [HRQoL]), preparedness, and decision-making self-efficacy...
March 1, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28237643/adjunctive-role-of-preoperative-liver-magnetic-resonance-imaging-for-potentially-resectable-pancreatic-cancer
#17
Hyoung Woo Kim, Jong-Chan Lee, Kyu-Hyun Paik, Jingu Kang, Young Hoon Kim, Yoo-Seok Yoon, Ho-Seong Han, Jaihwan Kim, Jin-Hyeok Hwang
BACKGROUND: The adjunctive role of magnetic resonance imaging of the liver before pancreatic ductal adenocarcinoma has been unclear. We evaluated whether the combination of hepatic magnetic resonance imaging with multidetector computed tomography using a pancreatic protocol (pCT) could help surgeons select appropriate candidates and decrease the risk of early recurrence. METHODS: We retrospectively enrolled 167 patients in whom complete resection was achieved without grossly visible residual tumor; 102 patients underwent pCT alone (CT group) and 65 underwent both hepatic magnetic resonance imaging and pCT (magnetic resonance imaging group)...
February 22, 2017: Surgery
https://www.readbyqxmd.com/read/28179342/phase-i-study-of-nab-paclitaxel-plus-gemcitabine-as-neoadjuvant-therapy-for-borderline-resectable-pancreatic-cancer
#18
Ken-Ichi Okada, Seiko Hirono, Manabu Kawai, Motoki Miyazawa, Atsushi Shimizu, Yuji Kitahata, Masaki Ueno, Shinya Hayami, Hiroki Yamaue
BACKGROUND/AIM: The aim of this study was to investigate the safety and feasibility of neoadjuvant nab-paclitaxel plus gemcitabine therapy for patients with borderline resectable pancreatic carcinoma (BRPC). PATIENTS AND METHODS: The study was a prospective single-center phase I trial for patients with BRPC. The primary endpoint was the toxicity, and secondary endpoints were the resection rate, the R0 resection rate and quality of life (QOL) regarding the peripheral sensory neuropathy (PSN)...
2017: Anticancer Research
https://www.readbyqxmd.com/read/28176472/suspected-atypical-haemolytic-uraemic-syndrome-in-two-post-partum-patients-with-foetal-death-in-utero-responding-to-eculizumab
#19
REVIEW
Justin Chua, Kathy Paizis, Simon Z He, Peter Mount
BACKGROUND: Atypical haemolytic uraemic syndrome (aHUS) is a rare condition with the triad of microangiopathic haemolytic anaemia, thrombocytopenia and acute kidney injury. Other conditions that present in a similar manner peri-partum include thrombotic thrombocytopaenic purpura, and pregnancy associated conditions including HELLP syndrome (haemolysis, elevated liver enzymes and low platelets), severe pre-eclampsia and less commonly acute fatty liver of pregnancy. CASE REPORTS: We describe two cases of suspected aHUS, who presented post-partum with foetal death-in-utero at 33 and 37 weeks respectively...
February 2017: Nephrology
https://www.readbyqxmd.com/read/28156569/differences-in-self-care-behaviors-by-varying-levels-of-caregiving-intensity-performance-and-well-being-among-family-caregivers-of-patients-with-high-mortality-cancer
#20
Wendy Demark-Wahnefried, Richard A Taylor, Gabrielle Betty Rocque, Andres Azuero, Aras Acemgil, Michelle Y Martin, Meka Astin, Deborah Ejem, Elizabeth Ann Kvale, Karen Heaton, Maria Pisu, Edward E Partridge, Marie Bakitas
239 Background: Family caregivers of high-mortality cancer patients perform vital tasks that deter from their own self-care. We aimed to determine differences in self-care behaviors by varying levels of caregiving intensity, well-being, and performance. METHODS: Cross-sectional survey conducted in community settings of 8 cancer centers in AL, FL, and TN. Two-hundred and ninety-four family caregivers of Medicare beneficiaries diagnosed with pancreatic, lung, brain, ovarian, head & neck, hematologic, or stage IV cancer completed measures of self-care behaviors, including health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, stress management, and sleep; anxiety and depression; health-related quality of life (HRQoL); caregiver competence and preparedness; and decision-making self-efficacy...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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