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Unresectable pancreas

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https://www.readbyqxmd.com/read/28078110/radioembolization-with-90-y-glass-microspheres-for-the-treatment-of-unresectable-metastatic-liver-disease-from-chemotherapy-refractory-gastrointestinal-cancers-final-report-of-a-prospective-pilot-study
#1
Nicholas Fidelman, Robert K Kerlan, Randall A Hawkins, Miguel Pampaloni, Andrew G Taylor, Maureen P Kohi, K Pallav Kolli, Chloe E Atreya, Emily K Bergsland, R Kate Kelley, Andrew H Ko, W Michael Korn, Katherine Van Loon, Ryan M McWhirter, Jennifer Luan, Curt Johanson, Alan P Venook
BACKGROUND: This prospective pilot single-institution study was undertaken to document the feasibility, safety, and efficacy of radioembolization of liver-dominant metastatic gastrointestinal cancer using (90)Y glass microspheres. METHODS: Between June 2010 and October 2013, 42 adult patients (26 men, 16 women; median age 60 years) with metastatic chemotherapy-refractory unresectable colorectal (n=21), neuroendocrine (n=11), intrahepatic bile duct (n=7), pancreas (n=2), and esophageal (n=1) carcinomas underwent 60 lobar or segmental administrations of (90)Y glass microspheres...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28072751/duodenal-plexiform-fibromyxoma-as-a-cause-of-obscure-upper-gastrointestinal-bleeding-a-case-report
#2
Demetrios Moris, Evangelia Spanou, Stavros Sougioultzis, Nikolaos Dimitrokallis, Polyxeni Kalisperati, Ioanna Delladetsima, Evangelos Felekouras
RATIONALE: We are reporting the first-to our knowledge-case of duodenal Plexiform Fibromyxoma causing obscure upper gastrointestinal bleeding. PATIENT CONCERNS: Plexiform fibromyxoma triggered recurrent upper gastrointestinal bleeding episodes in a 63-year-old man who remained undiagnosed, despite multiple hospitalizations, extensive diagnostic workups and surgical interventions (including gastrectomies), for almost 17 years. DIAGNOSES-INTERVENTIONS: During hospitalization for the last bleeding episode, an upper gastrointestinal endoscopy revealed an intestinal hemorrhagic nodule...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28018109/clinical-implications-of-doubling-time-of-gastrointestinal-submucosal-tumors
#3
Shuko Koizumi, Mitsuhiro Kida, Hiroshi Yamauchi, Kosuke Okuwaki, Tomohisa Iwai, Shiro Miyazawa, Miyoko Takezawa, Hiroshi Imaizumi, Wasaburo Koizumi
AIM: To evaluate the efficacy of doubling time (DT) of gastrointestinal submucosal tumors (GIST). METHODS: From April 1987 through November 2012, a total of 323 patients were given a final histopathological diagnosis of GISTs on surgical resection or endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in Kitasato University East Hospital or Kitasato University Hospital. We studied 53 of these patients (34 with resected tumors and 19 with unresected tumors) whose tumors could be measured on EUS on at least two successive occasions...
December 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27977628/percutaneous-irreversible-electroporation-for-pancreatic-vipoma-a-case-report
#4
Lizhi Niu, Jiannan Li, Jianying Zeng, Gang Fang, Liang Zhou, Kecheng Xu, Kai Zhang
The purpose of this study was to investigate the safety and efficacy of irreversible electroporation (IRE) for the management of unresectable pancreatic vasoactive intestinal peptide tumor (VIPoma) in a 34-year-old male patient. The initial symptom was watery diarrhea, which could not be stopped by fasting. Laboratory tests revealed high vasoactive intestinal peptide (VIP) hormone levels, hypokalemia, and metabolic acidosis. Computed tomography examination showed a 6.0 × 5.0-cm, contrast-enhanced lesion in the neck and body of the pancreas and obliteration of the portal vein...
January 2017: Pancreas
https://www.readbyqxmd.com/read/27938791/surveillance-for-neoplasia-in-the-pancreas
#5
REVIEW
Kasper A Overbeek, Djuna L Cahen, Marcia Irene Canto, Marco J Bruno
Despite its low incidence in the general population, pancreatic cancer is one of the leading causes of cancer-related mortality. Survival greatly depends on operability, but most patients present with unresectable disease. Therefore, there is great interest in the early detection of pancreatic cancer and its precursor lesions by surveillance. Worldwide, several programs have been initiated for individuals at high risk for pancreatic cancer. Their first results suggest that surveillance in high-risk individuals is feasible, but their effectiveness in decreasing mortality remains to be proven...
December 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27870918/time-dependent-impact-of-irreversible-electroporation-on-pancreas-liver-blood-vessels-and-nerves-a-systematic-review-of-experimental-studies
#6
J A Vogel, E van Veldhuisen, P Agnass, J Crezee, F Dijk, J Verheij, T M van Gulik, M R Meijerink, L G Vroomen, K P van Lienden, M G Besselink
INTRODUCTION: Irreversible electroporation (IRE) is a novel ablation technique in the treatment of unresectable cancer. The non-thermal mechanism is thought to cause mostly apoptosis compared to necrosis in thermal techniques. Both in experimental and clinical studies, a waiting time between ablation and tissue or imaging analysis to allow for cell death through apoptosis, is often reported. However, the dynamics of the IRE effect over time remain unknown. Therefore, this study aims to summarize these effects in relation to the time between treatment and evaluation...
2016: PloS One
https://www.readbyqxmd.com/read/27857025/efficacy-of-chemotherapy-in-patients-with-unresectable-or-metastatic-pancreatic-acinar-cell-carcinoma-potentially-improved-efficacy-with-oxaliplatin-containing-regimen
#7
Changhoon Yoo, Bum Jun Kim, Kyu-Pyo Kim, Jae-Lyun Lee, Tae Won Kim, Baek-Yeol Ryoo, Heung-Moon Chang
Purpose: Pancreatic acinar cell carcinoma (ACC) is a rare cancer of the exocrine pancreas. Because of its rare incidence, the efficacy of chemotherapy in this patient population has been largely unknown. Therefore, we retrospectively analyzed the outcomes of patients with advanced pancreatic ACC who received chemotherapy. Materials and Methods: Between January 1997 and March 2015, 15 patients with unresectable or metastatic pancreatic ACC who received systemic chemotherapy were identified in Asan Medical Center, Korea...
November 9, 2016: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/27855353/challenging-the-limits-in-pancreatic-surgery-a-case-report
#8
Johannes Lemke, Stefan A Schmidt, Marko Kornmann, Karl-Heinz Orend, Doris Henne-Bruns
INTRODUCTION: Today, pancreatic surgery can be performed with low mortality and tolerable morbidity in specialized centers. Nevertheless, due to its anatomical localization and proximity to important vascular structures, surgical resection of the pancreas remains challenging in many cases. PRESENTATION OF CASE: Here, we present the case of a young woman who presented in our department with abdominal pain and a tumor mass located at the pancreatic head. She had undergone explorative laparotomy elsewhere before, in which the pancreatic tumor mass was reported to be unresectable due to infiltration of the mesenteric root...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27853997/a-phase-i-trial-investigating-pulsatile-erlotinib-in-combination-with-gemcitabine-and-oxaliplatin-in-advanced-biliary-tract-cancers
#9
Laura W Goff, Dana B Cardin, Jennifer G Whisenant, Liping Du, Tatsuki Koyama, Kimberly B Dahlman, Safia N Salaria, Ruth T Young, Kristen K Ciombor, Jill Gilbert, Stephen James Smith, Emily Chan, Jordan Berlin
Advanced biliary tract cancers (ABTC) are among the deadliest malignancies with limited treatment options after progression on standard-of-care chemotherapy, which includes gemcitabine (GEM) and oxaliplatin (OX). The epidermal growth factor receptor inhibitor erlotinib has been explored in ABTC with modest efficacy. Erlotinib given continuously may antagonize the action of chemotherapy against cycling tumor cells, but pulsatile dosing of erlotinib with chemotherapy may improve efficacy. The purpose of this study was to assess the safety of pulsatile erlotinib with GEMOX...
November 16, 2016: Investigational New Drugs
https://www.readbyqxmd.com/read/27813710/usefulness-of-three-dimensional-modeling-in-surgical-planning-resident-training-and-patient-education
#10
Ciro Andolfi, Alejandro Plana, Patrick Kania, P Pat Banerjee, Stephen Small
BACKGROUND: Imaging has a critical impact on surgical decision making and three-dimensional (3D) digital models of patient pathology can now be made commercially. We developed a 3D digital model of a cancer of the head of the pancreas by integrating actual CT data with 3D modeling process. After this process, the virtual pancreatic model was also produced using a high-quality 3D printer. PATIENTS AND METHODS: A 56-year-old female with pancreatic head adenocarcinoma presented with biliary obstruction and jaundice...
November 4, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27794194/risk-factors-for-latent-distant-organ-metastasis-detected-by-staging-laparoscopy-in-patients-with-radiologically-defined-locally-advanced-pancreatic-ductal-adenocarcinoma
#11
Ilhan Karabicak, Sohei Satoi, Hiroaki Yanagimoto, Tomohisa Yamamoto, Satoshi Hirooka, So Yamaki, Hisashi Kosaka, Kentaro Inoue, Yoichi Matsui, Masanori Kon
OBJECTIVES: We aimed to identify risk factors for latent distant organ metastasis in patients with radiographically defined locally advanced (RDLA) pancreatic ductal adenocarcinoma (PDAC). METHODS: RDLA disease was defined as unresectable disease without distant organ metastasis based on resectability status by NCCN guidelines. Between January 2005 and November 2015, 110 consecutive patients underwent staging laparoscopy to rule out latent distant metastasis. Univariate and multivariate analyses were performed to identify risk factors for latent distant organ metastasis or peritoneal metastasis (PM), defined as peritoneal dissemination and/or positive peritoneal lavage cytology (PPC)...
December 2016: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/27756258/development-of-oxy111a-a-novel-hypoxia-modifier-as-a-potential-antitumor-agent-in-patients-with-hepato-pancreato-biliary-neoplasms-protocol-of-a-first-ib-iia-clinical-trial
#12
Perparim Limani, Michael Linecker, Philipp Kron, Panagiotis Samaras, Bernhard Pestalozzi, Roger Stupp, Alexander Jetter, Philipp Dutkowski, Beat Müllhaupt, Andrea Schlegel, Claude Nicolau, Jean-Marie Lehn, Henrik Petrowsky, Bostjan Humar, Rolf Graf, Pierre-Alain Clavien
BACKGROUND: Solid tumors, such as hepato-pancreato-biliary cancer, develop tumor hypoxia with tumor growth. Despite advances in surgery, a majority of these patients are in an unresectable condition. At this stage standard cytotoxic chemotherapy regimens are applied with limited success. Novel biological treatment options based on an antiangiogenic mechanism of action neglect other hypoxia mediated mechanisms (e.g. epithelial-mesenchymal transition, Warburg effect, and immunological response) leading to an increased invasiveness with a poor outcome...
October 19, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27742480/assessing-the-role-of-primary-tumour-resection-in-patients-with-synchronous-unresectable-liver-metastases-from-pancreatic-neuroendocrine-tumour-of-the-body-and-tail-a-propensity-score-survival-evaluation
#13
E Bertani, N Fazio, D Radice, C Zardini, G Spinoglio, A Chiappa, D Ribero, R Biffi, S Partelli, M Falconi
BACKGROUND: The role of primary tumour surgery in pancreatic neuroendocrine tumours (PNETs) with unresectable liver metastases is controversial and international guidelines do not recommend surgery in such cases. Resectability of the primary tumour has never been considered in outcome comparisons between operated and non-operated patients. METHODS: From two institutional prospective databases of patients affected by PNET and unresectable liver metastases, 63 patients who underwent a left-pancreatectomy at diagnosis were identified and compared with a group of 30 patients with a potentially resectable but not-resected primary tumour located in the body or tail...
September 30, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27734516/follicular-dendritic-cell-sarcoma-treated-with-a-variety-of-chemotherapy
#14
Masaoki Sasaki, Hiroaki Izumi, Takaaki Yokoyama, Motohiro Kojima, Ako Hosono
Follicular dendritic cell sarcoma (FDCS) is a very rare malignant tumor derived from follicular dendritic cells. Radical resection is the standard therapy for patients with local disease, but an optimal chemotherapy regimen has not been determined for unresectable disease. We report our experience of an FDCS patient with multiorgan involvement. In the present case, disease was only located in the pancreas initially and radical resection was performed. Multiple metastasis developed after the treatment and several factors that indicated a poor prognosis were observed...
October 13, 2016: Hematological Oncology
https://www.readbyqxmd.com/read/27631326/diagnostic-accuracy-of-different-imaging-modalities-following-computed-tomography-ct-scanning-for-assessing-the-resectability-with-curative-intent-in-pancreatic-and-periampullary-cancer
#15
REVIEW
Domenico Tamburrino, Deniece Riviere, Mohammad Yaghoobi, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: Periampullary cancer includes cancer of the head and neck of the pancreas, cancer of the distal end of the bile duct, cancer of the ampulla of Vater, and cancer of the second part of the duodenum. Surgical resection is the only established potentially curative treatment for pancreatic and periampullary cancer. A considerable proportion of patients undergo unnecessary laparotomy because of underestimation of the extent of the cancer on computed tomography (CT) scanning. Other imaging methods such as magnetic resonance imaging (MRI), positron emission tomography (PET), PET-CT, and endoscopic ultrasound (EUS) have been used to detect local invasion or distant metastases not visualised on CT scanning which could prevent unnecessary laparotomy...
September 15, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27539084/endoscopic-ultrasound-fine-needle-aspiration-diagnosis-of-synchronous-primary-pancreatic-adenocarcinoma-and-effects-on-staging-and-resectability
#16
Tarun Rustagi, Ferga C Gleeson, Suresh T Chari, Barham K Abu Dayyeh, Michael B Farnell, Prasad G Iyer, Michael L Kendrick, Randall K Pearson, Bret T Petersen, Elizabeth Rajan, Mark D Topazian, Mark J Truty, Santhi S Vege, Kenneth K Wang, Michael J Levy
Synchronous primary pancreatic adenocarcinoma, defined as the simultaneous presence of 2 or more newly identified and anatomically separate primary adenocarcinomas within the pancreas, is reported rarely. We compared endoscopic ultrasound (EUS) and computed tomography (CT) and magnetic resonance imaging (MRI) findings from patients with synchronous primary pancreatic adenocarcinoma and their effects on cancer staging and treatment. We performed a retrospective analysis of the EUS database at the Mayo Clinic, from September 2008 through May 2016, to collect EUS, CT, MRI, and clinical data from patients with synchronous primary pancreatic adenocarcinoma...
August 15, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27422109/acr-appropriateness-criteria%C3%A2-borderline-and-unresectable-pancreas-cancer
#17
REVIEW
William Small, John P Hayes, W Warren Suh, May Abdel-Wahab, Ross A Abrams, Nilofer Azad, Prajnan Das, Jadranka Dragovic, Karyn A Goodman, Salma K Jabbour, William E Jones, Andre A Konski, Albert C Koong, Rachit Kumar, Percy Lee, Timothy M Pawlik, Joseph M Herman
The American College of Radiology Appropriateness Criteria® are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment...
July 2016: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/27403106/hematogenous-gastric-metastasis-of-pancreatic-cancer
#18
Junpei Sasajima, Kotaro Okamoto, Masato Taniguchi
While the gastric involvement of pancreatic cancer is occasionally observed as the result of direct invasion, hematogenous gastric metastasis is rare. A 72-year-old Japanese male presented with general fatigue, pollakiuria, and thirst. Computed tomography revealed a 4.6-cm solid mass in the pancreatic tail and a 4.2-cm multilocular cystic mass in the pancreatic head with multiple liver and lymphatic metastasis. Notably, two solid masses were detected in the gastric wall of the upper body and the antrum; both were separated from the primary pancreatic cancer and seemed to be located in the submucosal layer...
January 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27250045/efficacy-and-safety-of-endoscopic-gallbladder-stenting-for-acute-cholecystitis-in-patients-with-concomitant-unresectable-cancer
#19
Takeshi Hatanaka, Takao Itoi, Masashi Ijima, Ayako Matsui, Eishin Kurihara, Nozomi Okuno, Tsutomu Kobatake, Satoru Kakizaki, Masanobu Yamada
Objective Endoscopic gallbladder stenting (EGBS) is an alternative treatment option for high-risk surgical patients with acute cholecystitis. However, there are no reports focusing on EGBS in patients with concomitant unresectable cancer. The aim of this study was thus to evaluate EGBS in such patients. Methods Twenty-two consecutive patients with acute cholecystitis and unresectable cancer were enrolled between September 2010 and December 2014. Their median age was 74.5 years (range: 51-95). Thirteen patients were men and nine were women...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27234865/-autoimmune-pancreatitis-as-an-element-of-autoimmune-polyglandular-syndrome
#20
Przemysław Dyrla, Tomasz Nowak, Jerzy Gil, Cezary Adamiec, Mariusz Bobula, Marek Saracyn
Autoimmune pancreatitis constantly belongs to diseases which often causes significant diagnostic problem and often runs out with surgical intervention as considered to be a pancreatic cancer. Important although usually underestimated problems are polyglandular syndromes, which may consist of autoimmune pancreatitis (AIP) problem as well. This case report is an example of autoimmune polyglandular syndrome (APS), which was connected with the surgical treatment with biliary bypass anastomosis because of the unresectable lesion in the head of pancreas...
May 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
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