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https://www.readbyqxmd.com/read/28620900/new-treatment-options-and-management-considerations-in-borderline-resectable-pancreatic-cancer
#1
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/28567455/laparoscopic-total-pancreatectomy-for-multiple-metastasis-of-renal-cell-carcinoma-of-the-pancreas-a-case-report-and-literature-review
#2
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/28468714/the-indications-for-laparoscopic-pancreatectomy
#3
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/28385584/a-study-of-the-clinical-utility-of-a-20-minute-secretin-stimulated-endoscopic-pancreas-function-test-and-performance-according-to-clinical-variables
#4
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/28133191/-a-case-of-successful-stomach-preserving-pancreaticoduodenectomy-with-celiac-artery-resection-after-neoadjuvant-chemoradiation-therapy-for-pancreatic-cancer-with-hepatic-arterial-variation
#5
Yukie Kyakumoto, Masamichi Mizuma, Tomoya Abe, Tatsuyuki Takadate, Koji Fukase, Hideo Otsuka, Naoaki Sakata, Kei Nakagawa, Takanori Morikawa, Hiroki Hayashi, Takeshi Naitoh, Fuyuhiko Motoi, Atsushi Kanno, Tooru Shimosegawa, Michiaki Unno
Here we report a case of successful stomach-preserving pancreaticoduodenectomy with celiac artery resection for pancreatic cancer with hepatic arterial variation. A 70-year-old woman was referred to our hospital for examination and treatment of pancreatic cancer. A CT scan showed a tumor with suspected portal vein invasion at the body and head of the pancreas, in contact with the common hepatic artery and the splenic artery with 360°involvement. Contact with the celiac artery and left gastric artery was less than1 80°...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133097/-a-study-of-gemctabine-plus-nab-paclitaxel-therapy-for-advanced-local-progressive-pancreatic-cancer
#6
Yutaka Itoh, Hiroyuki Saito, Shunsuke Yamagishi, Yuki Suematsu, Miyuki Takahashi, Mao Nakayama, Michiko Fukabori, Akihiko Morita, Kazuhiko Wakabayashi
We studied the significance of gemcitabine plus nab-paclitaxel(GnP)therapy for locally progressive pancreatic cancer. We enrolled 10 patients with local progression without distant metastasis. We used GnP therapy for the ablative borderline resectable(BR)and unresectable(UR)cases based on images that followed NCCN pancreatic cancer treatment guidelines. In 1 case of resectable(R)pancreatic cancer, the tumor was located in the pancreas body but we determined that surgery was impossible because of the underlying disease detected on imaging analysis...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28105634/does-radiologic-response-correlate-to-pathologic-response-in-patients-undergoing-neoadjuvant-therapy-for-borderline-resectable-pancreatic-malignancy
#7
Brent T Xia, Baojin Fu, Jiang Wang, Young Kim, S Ameen Ahmad, Vikrom K Dhar, Nick C Levinsky, Dennis J Hanseman, David A Habib, Gregory C Wilson, Milton Smith, Olugbenga O Olowokure, Jordan Kharofa, Ali H Al Humaidi, Kyuran A Choe, Daniel E Abbott, Syed A Ahmad
BACKGROUND AND OBJECTIVES: In patients with borderline resectable pancreas cancers, clinicians frequently consider radiographic response as the primary driver of whether patients should be offered surgical intervention following neoadjuvant therapy (NT). We sought to determine any correlation between radiographic and pathologic response rates following NT. METHODS: Between 2005 and 2015, 38 patients at a tertiary care referral center underwent NT followed by pancreaticoduodenectomy for borderline resectable pancreas cancer...
March 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28048258/su-f-r-47-quantitative-shape-relationship-analysis-of-ptv-modification-for-critical-anatomy-sparing-and-its-impact-on-pathologic-response-for-neoadjuvant-stereotactic-radiotherapy-for-pancreatic-cancer
#8
Z Cheng, L Rosati, L Chen, S Robertson, J Moore, L Peng, O Mian, A Narang, A Hacker-Prietz, J Herman, T McNutt
PURPOSE: Stereotactic body radiation therapy (SBRT) may be used to increase surgery candidacy in borderline resectable (BRPC) and locally advanced (LAPC) pancreatic cancer. However, the planning target volume (PTV) may need to be limited to avoid toxicity when the gross tumor volume (GTV) is anatomically involved with surrounding critical structures. Our study aims to characterize the coverage of GTV and investigate the association between modified PTV and pathologic (pCR) or near pathologic (npCR) complete response rates determined from the surgical specimen...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/27993362/factors-associated-with-decisional-regret-among-patients-undergoing-major-thoracic-and-abdominal-operations
#9
Ana Wilson, Megan Winner, Alexander Yahanda, Nikolaos Andreatos, Sean Ronnekleiv-Kelly, Timothy M Pawlik
BACKGROUND: No study has specifically investigated patient attitudes on decisional regret concerning major operative procedures. The objective of the present study was to define the prevalence of regret among patients who had undergone a major abdominal or thoracic operative procedure and to identify factors associated with postoperative regret. METHODS: Decisional regret was assessed using the validated Decision Regret Scale, which consisted of 5 items with Likert-scale responses...
December 16, 2016: Surgery
https://www.readbyqxmd.com/read/27895766/primary-mesenchymal-tumors-of-the-pancreas-in-a-single-center-over-15-years
#10
Hongkai Zhang, Shuangni Yu, Wenze Wang, Yin Cheng, Yu Xiao, Zhaohui Lu, Jie Chen
In total, 95% of primary tumors in the pancreas are epithelial tumors; primary mesenchymal tumors at this site are extremely rare. At present, only one comprehensive study about these rare tumors has been performed. Another retrospective analysis of these rare tumors is performed in the present study, which, to the best of our knowledge, is the first to be performed in China. In the present study, 10 patients that underwent resection for primary mesenchymal tumors of the pancreas were identified in a 15-year period at the Chinese Academy of Medical Sciences and Peking Union Medical College, which accounted for 0...
November 2016: Oncology Letters
https://www.readbyqxmd.com/read/27885876/predictors-and-survival-for-pathologic-tumor-response-grade-in-borderline-resectable-and-locally-advanced-pancreatic-cancer-treated-with-induction-chemotherapy-and-neoadjuvant-stereotactic-body-radiotherapy
#11
Eric A Mellon, William H Jin, Jessica M Frakes, Barbara A Centeno, Tobin J Strom, Gregory M Springett, Mokenge P Malafa, Ravi Shridhar, Pamela J Hodul, Sarah E Hoffe
BACKGROUND: Neoadjuvant therapy response correlates with survival in multiple gastrointestinal malignancies. To potentially augment neoadjuvant response for pancreas adenocarcinoma, we intensified treatment with stereotactic body radiotherapy (SBRT) following multi-agent chemotherapy. Using this regimen, we analyzed whether the College of American Pathology (CAP) tumor regression grade (TRG) at pancreatectomy correlated with established response biomarkers and survival. MATERIALS AND METHODS: We identified borderline resectable (BRPC) and locally advanced (LAPC) pancreatic cancer patients treated according to our institutional clinical pathway who underwent surgical resection with reported TRG (n = 81, median follow-up after surgery 24...
March 2017: Acta Oncologica
https://www.readbyqxmd.com/read/27864998/rnf43-mutation-frequently-occurs-with-gnas-mutation-and-mucin-hypersecretion-in-intraductal-papillary-neoplasms-of-the-bile-duct
#12
Jia-Huei Tsai, Jau-Yu Liau, Chang-Tsu Yuan, Mei-Ling Cheng, Ray-Hwang Yuan, Yung-Ming Jeng
AIMS: RNF43 is a tumour suppressor gene that suppresses the Wnt-β-catenin signalling pathway. We investigated the role of RNF43 in intraductal papillary neoplasm of the bile duct (IPNB). METHODS AND RESULTS: We conducted mutation analysis of RNF43 in 50 IPNBs, and identified six (12%) RNF43 mutations. RNF43 mutation was more frequent in the intestinal subtype of IPNB (17%) than in the gastric/pancreatobiliary subtype (5%). There was a strong association of RNF43 mutation with GNAS (P = 0...
April 2017: Histopathology
https://www.readbyqxmd.com/read/27813710/usefulness-of-three-dimensional-modeling-in-surgical-planning-resident-training-and-patient-education
#13
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...
May 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27491323/robotic-enucleation-for-benign-or-borderline-tumours-of-the-pancreas-a-retrospective-analysis-and-comparison-from-a-high-volume-centre-in-asia
#14
Jia-Bin Jin, Kai Qin, Hua Li, Zhi-Chong Wu, Qian Zhan, Xia-Xing Deng, Hao Chen, Bai-Yong Shen, Cheng-Hong Peng, Hong-Wei Li
BACKGROUND: Enucleation is increasingly performed for benign or borderline tumours of the pancreas because it is a parenchyma-sparing and less invasive procedure compared to conventional pancreatectomy, which reduces the risk of exocrine and endocrine insufficiency. This study retrospectively evaluated and compared the pre-, intra-, and post-operative clinical characteristics after open and robotic approaches for pancreatic enucleation. METHODS: Fifty-six cases of enucleation for benign or borderline tumours of the pancreas treated from March 2010 to July 2015 were identified by a retrospective search...
August 4, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27468199/preoperative-defining-system-for-pancreatic-head-cancer-considering-surgical-resection
#15
Seok Jeong Yang, Ho Kyoung Hwang, Chang Moo Kang, Woo Jung Lee
AIM: To provide appropriate treatment, it is crucial to share the clinical status of pancreas head cancer among multidisciplinary treatment members. METHODS: A retrospective analysis of the medical records of 113 patients who underwent surgery for pancreas head cancer from January 2008 to December 2012 was performed. We developed preoperative defining system of pancreatic head cancer by describing "resectability - tumor location - vascular relationship - adjacent organ involvement - preoperative CA19-9 (initial bilirubin level) - vascular anomaly"...
July 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27422109/acr-appropriateness-criteria%C3%A2-borderline-and-unresectable-pancreas-cancer
#16
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/27180967/analysis-of-clostridium-difficile-infections-in-patients-hospitalized-at-the-nephrological-ward-in-poland
#17
Agata Kujawa-Szewieczek, Marcin Adamczak, Katarzyna Kwiecień, Sylwia Dudzicz, Zofia Prażak, Andrzej Więcek
BACKGROUND: Few studies have evaluated the incidence and risk factors of Clostridium difficile infection (CDI) in the adult Polish population, in particular in solid organ recipients hospitalized at the nephrological ward. AIM: The aim of this study was to analyze Clostridium difficile infections (CDI) among patients hospitalized in the Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia in Katowice. MATERIAL/METHODS: Thirty-seven patients with Clostridium difficile infection diagnosed between October 2011 and November 2013 (26 months), identified among a total of 3728 patients hospitalized in this department during this period, were included in this retrospective, single-center study...
2016: Postȩpy Higieny i Medycyny Doświadczalnej
https://www.readbyqxmd.com/read/27160088/robotic-assisted-approach-improves-vessel-preservation-in-spleen-preserving-distal-pancreatectomy
#18
Sabine Eckhardt, Christoph Schicker, Elisabeth Maurer, Volker Fendrich, Detlef K Bartsch
BACKGROUND: Vessel-preserving spleen preservation (SP) during distal pancreatectomy (DP) is supposed to be beneficial for patients with benign and borderline tumors. This study evaluated the first experiences with robotic-assisted laparoscopic DP (RA-LDP) and its rate of vessel preservation and SP compared to conventional laparoscopic DP (C-LDP). METHODS: Patients scheduled for spleen-preserving DP for benign or borderline tumors by either C-LDP or RA-LDP were retrieved from a prospective database and retrospectively analyzed regarding vessel-preservation and SP, conversion rate, blood loss, operating time, complications, perioperative blood transfusion, postoperative hospital stay (PHS) and mortality...
2016: Digestive Surgery
https://www.readbyqxmd.com/read/27103487/na-micro-current-value-detection-as-a-new-modality-for-identification-of-benign-and-malignant-disease-in-surgery
#19
Xu-Feng Zhang, Zhi-Da Long, Xue-Min Liu, Feng Ma, Qiang Li, Yi Lv
Increase of intracellular positive ions (mainly Na(+)) indicates greater possibility of cell malignancy. The present study investigated the correlation between the Na(+) micro-current value (MCV) and tissue characteristics (normal, benign or malignant). 346 tissue samples have been detected within 30 min after surgical isolation by Na(+) detector. MCV in 102 malignant tumor was significantly higher than that in benign/borderline tumor or normal tissue (33.3 ± 8.9 μA vs. 24.4 ± 8.6 μA and 14...
2016: Scientific Reports
https://www.readbyqxmd.com/read/27072997/laparoscopic-radical-extended-right-hemicolectomy-using-a-caudal-to-cranial-approach
#20
Liaonan Zou, Wenjun Xiong, Delong Mo, Yaobin He, Hongming Li, Ping Tan, Wei Wang, Jin Wan
BACKGROUND: Due to the emphasis of oncologic principle, a medial-to-lateral approach for laparoscopic right hemicolectomy was recommended.1 (,) 2 This approach, however, is technically challenging and involves several limitations with overweight patients, whose mesocolon may be too thick for identification of the vessel landmarks. Moreover, it is difficult for inexperienced surgeons to enter the retroperitoneum space accurately. This report describes a caudal-to-cranial approach for laparoscopic radical extended right hemicolectomy...
August 2016: Annals of Surgical Oncology
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