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Pancreatic cancer surgery

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https://www.readbyqxmd.com/read/28338506/a-preliminary-report-radical-surgery-and-stem-cell-transplantation-for-the-treatment-of-patients-with-pancreatic-cancer
#1
Brigitta Omazic, Burcu Ayoglu, Matthias Löhr, Ralf Segersvärd, Caroline Verbeke, Isabelle Magalhaes, Zuzana Potacova, Jonas Mattsson, Alexei Terman, Sam Ghazi, Nils Albiin, Nikolaos Kartalis, Peter Nilsson, Thomas Poiret, Liu Zhenjiang, Rainer Heuchel, Jochen M Schwenk, Johan Permert, Markus J Maeurer, Olle Ringden
We examined the immunologic effects of allogeneic hematopoietic stem cell transplantation (HSCT) in the treatment of pancreatic ductal adenocarcinoma, a deadly disease with a median survival of 24 months for resected tumors and a 5-year survival rate of 6%. After adjuvant chemotherapy, 2 patients with resected pancreatic ductal adenocarcinoma underwent HSCT with HLA-identical sibling donors. Comparable patients who underwent radical surgery, but did not have a donor, served as controls (n=6). Both patients developed humoral and cellular (ie, HLA-A*01:01-restricted) immune responses directed against 2 novel tumor-associated antigens (TAAs), INO80E and UCLH3 after HSCT...
March 23, 2017: Journal of Immunotherapy
https://www.readbyqxmd.com/read/28335509/novel-diagnostic-and-predictive-biomarkers-in-pancreatic-adenocarcinoma
#2
REVIEW
John C Chang, Madappa Kundranda
Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal disease for a multitude of reasons including very late diagnosis. This in part is due to the lack of understanding of the biological behavior of PDAC and the ineffective screening for this disease. Significant efforts have been dedicated to finding the appropriate serum and imaging biomarkers to help early detection and predict response to treatment of PDAC. Carbohydrate antigen 19-9 (CA 19-9) has been the most validated serum marker and has the highest positive predictive value as a stand-alone marker...
March 20, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28332353/port-site-metastases-and-chimney-effect-of-b-ultrasound-guided-and-laparoscopically-assisted-hyperthermic-intraperitoneal-perfusion-chemotherapy
#3
Ming Chen Ba, Hui Long, Xiang Liang Zhang, Yuan Feng Gong, Zhao Fei Yan, Shuai Wang, Yun Qiang Tang, Shu Zhong Cui
PURPOSE: CO₂ leakage along the trocar (chimney effect) has been proposed to be an important factor underlying port-site metastasis after laparoscopic surgery. This study aimed to test this hypothesis by comparing the incidence of port-site metastasis between B-ultrasound-guided and laparoscopically-assisted hyperthermic intraperitoneal perfusion chemotherapy (HIPPC). MATERIALS AND METHODS: Sixty-two patients with malignant ascites induced by gastrointestinal or ovarian cancer were divided into two groups to receive either B-ultrasound-guided or laparoscopically-assisted HIPPC...
May 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28326457/minimally-invasive-surgical-approaches-for-pancreatic-adenocarcinoma-recent-trends
#4
REVIEW
Georgios D Lianos, Dimitrios K Christodoulou, Konstantinos H Katsanos, Christos Katsios, Georgios K Glantzounis
BACKGROUND: Pancreatic resection for cancer represents a real challenge for every surgeon. Recent improvements in laparoscopic experience, minimally invasive surgical techniques and instruments make now the minimally invasive approach a real "triumph." There is no doubt that minimally invasive surgery has replaced with great success conventional surgery in many fields, including surgical oncology. METHODS AND RESULTS: However, its progress in pancreatic resection for adenocarcinoma has been dramatically slow...
March 22, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28318082/histopathological-tumour-viability-after-neoadjuvant-chemotherapy-influences-survival-in-resected-pancreatic-cancer-analysis-of-early-outcome-data
#5
Phil Townend, Phil R de Reuver, Terence C Chua, Anubhav Mittal, Stephen J Clark, Nick Pavlakis, Anthony J Gill, Jaswinder S Samra
BACKGROUND: Neoadjuvant therapy is increasingly recognized as an effective strategy prior to pancreatoduodenectomy. We investigate the role of neoadjuvant chemotherapy (NAC) followed by surgery and the predictive role of viable residual tumour cells histopathologically on outcomes. METHODS: The study population comprised of 195 consecutive patients with pancreatic adenocarcinoma who were treated with either NAC or a surgery-first (SF) strategy. Histopathological viable tumour cells were examined in the NAC patients and clinicopathological factors were correlated with overall survival...
March 20, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28317015/evaluation-of-the-2015-aga-guidelines-on-pancreatic-cystic-neoplasms-in-a-large-surgically-confirmed-multicenter-cohort
#6
Phillip S Ge, V Raman Muthusamy, Srinivas Gaddam, Diana-Marie Jaiyeola, Stephen Kim, Alireza Sedarat, Timothy R Donahue, Lindsay Hosford, Robert H Wilson, David P Grande, Rajesh N Keswani, Vladimir M Kushnir, Daniel Mullady, Steven A Edmundowicz, Dayna S Early, Srinadh Komanduri, Sachin Wani, Rabindra R Watson
Background and study aims The American Gastroenterological Association (AGA) recently published guidelines for the management of asymptomatic pancreatic cystic neoplasms (PCNs). We aimed to evaluate the diagnostic characteristics of the AGA guidelines in appropriately recommending surgery for malignant PCNs. Patients and methods A retrospective multicenter study was performed of patients who underwent endoscopic ultrasound (EUS) for evaluation of PCNs who ultimately underwent surgical resection from 2004 - 2014...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28316225/-the-clinical-impact-of-artery-first-approach-combined-with-vascular-resection-and-reconstruction-in-the-treatment-of-pancreatic-head-carcinoma
#7
J L Huang, W G Li, F Z Chen, Z J Su, F M Li, B Liu
Objective: To evaluate the application of artery first, combined vascular resection and reconstruction in the treatment of pancreatic head carcinoma. Methods: The clinical data of 13 patients with pancreatic head cancer were retrospectively analyzed from February 2014 to March 2016 in the Affiliated Hospital of Xiamen University. Preoperative computed tomography of high resolution layer or magnetic resonance imaging examination demonstrated pancreatic head carcinoma, as well as close adhesion, stenosis, compression or displacement of superior mesenteric vein or portal vein wall...
March 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28314312/surgical-resection-for-pulmonary-metastasis-from-pancreatic-and-biliary-tract-cancer
#8
Tetsuzo Tagawa, Kensaku Ito, Kengo Fukuzawa, Tatsuro Okamoto, Atsuro Yoshimura, Takahide Kawasaki, Takashi Masuda, Kentaro Iwaki, Takahiro Terashi, Masahiro Okamoto, Akio Shiromizu, Akira Motohiro, Yoshihiko Maehara
AIM: To determine the efficacy of pulmonary metastasectomy for pancreatic and biliary tract cancer. PATIENTS AND METHODS: Ten patients who underwent therapeutic pulmonary metastasectomy after resection for pancreatic and biliary tract cancer at our Institution from 2006 to 2016 were retrospectively evaluated. RESULTS: The primary site was the pancreas in four patients and biliary tract in six. Nine patients had single metastasis, and one patient had bilateral multiple metastases...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28303874/-radical-oncological-stomach-liver-and-pancreatic-surgery-in-patients-over-80-years-old
#9
V K Lyadov, I A Kozyrin, Z A Kovalenko
AIM: To analyze the results of radical surgery for upper GI cancer in patients ≥80 years old. MATERIAL AND METHODS: For the period November 2010 - June 2015 there were 14 radical operations in elderly (≥80 years) patients with gastric, liver and pancreatic tumors. There were 4 Whipple procedures, 4 total and 2 distal gastrectomies, 1 total pancreatectomy as well as a central liver resection, one laparoscopic 5 segment resection and one 2, 3, 7 segment resection...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28298257/the-diagnostic-advantage-of-eob-mr-imaging-over-ct-in-the-detection-of-liver-metastasis-in-patients-with-potentially-resectable-pancreatic-cancer
#10
Takaaki Ito, Teiichi Sugiura, Yukiyasu Okamura, Yusuke Yamamoto, Ryo Ashida, Takeshi Aramaki, Masahiro Endo, Katsuhiko Uesaka
BACKGROUND: Liver metastases (LMs) are sometimes diagnosed intraoperatively, even when multidetector-row computed tomography (MDCT) reveals no LM in the staging of pancreatic cancer (PC). Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MR imaging) may have a role to play in the detection of LM. METHODS: The present study included a total of 201 patients who underwent an EOB-MR imaging examination before undergoing surgical resection for pancreatic cancer that was determined to be radiologically-resectable by MDCT...
March 8, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28297830/-ct-typing-and-surgical-approach-for-adenocarcinoma-of-the-esophagogastric-junction
#11
Y Z Zhao, G S Han, P F Ma, J Li, C Y Liu, M K Huo
Objective: To investigate the feasibility, safety and efficacy of preoperative CT in the classification of adenocarcinoma of the esophagogastric junction. Methods: A total of 517 consecutive patients from May 2012 to June 2016 with esophagogastric junction carcinoma in the department of general surgery of Henan Cancer Hospital was retrospectively analyzed, according to the clinical pathological data of three type four layer method and statistics of various types of surgery in patients with preoperative enhanced CT...
March 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28293721/post-whipple-imaging-in-patients-with-pancreatic-ductal-adenocarcinoma-association-with-overall-survival-a-multivariate-analysis
#12
Azadeh Elmi, Janet Murphy, Sandeep Hedgire, Shaunagh McDermott, Seyed-Mahdi Abtahi, Elkan Halpern, Carlos Fernandez-Del Castillo, Mukesh Harisinghani
PURPOSE: To compare the survival outcomes in patients with pancreatic ductal adenocarcinoma (PDAC) who had regular imaging surveillance with those who had clinical follow-up after Whipple. METHOD: We identified 229 patients, who underwent Whipple for resection of PDAC from 2005 to 2011, and had regular postoperative clinical follow-up at our hospital. Patients were retrospectively selected for two follow-up groups: imaging surveillance (IS) defined as routine imaging at scheduled intervals, vs...
March 14, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28287935/heterotopic-pancreas-histopathologic-features-imaging-findings-and-complications
#13
Maryam Rezvani, Christine Menias, Kumaresan Sandrasegaran, Jeffrey D Olpin, Khaled M Elsayes, Akram M Shaaban
Heterotopic pancreas is a congenital anomaly in which pancreatic tissue is anatomically separate from the main gland. The most common locations of this displacement include the upper gastrointestinal tract-specifically, the stomach, duodenum, and proximal jejunum. Less common sites are the esophagus, ileum, Meckel diverticulum, biliary tree, mesentery, and spleen. Uncomplicated heterotopic pancreas is typically asymptomatic, with the lesion being discovered incidentally during an unrelated surgery, during an imaging examination, or at autopsy...
March 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28285538/the-prospective-of-laparoscopic-pancreaticoduodenectomy-for-cancer-management
#14
REVIEW
Hendi Maher, Weiwei Jin, Yiping Mou, Henry Davies
Laparoscopic pancreaticoduodenectomy (LPD) is an extremely challenging surgery. First described in 1994, LPD has been gaining a favorable position in the majority of pancreatic surgery. Now, LPD is worldwide accepted. A literature search was conducted in PubMed, and only papers written in English containing more than 26 publications of LPD were selected. Papers in distal and robotic pancreatic procedure were not included in the review of a total of 222 LPD publications. The total number of patients analyzed was 1,082 from 25 articles and the largest series...
February 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28285387/development-and-external-validation-of-preoperative-risk-models-for-operative-morbidities-after-total-gastrectomy-using-a-japanese-web-based-nationwide-registry
#15
Hirotoshi Kikuchi, Hiroaki Miyata, Hiroyuki Konno, Kinji Kamiya, Ai Tomotaki, Mitsukazu Gotoh, Go Wakabayashi, Masaki Mori
BACKGROUND: Total gastrectomy is a relatively difficult and invasive procedure among gastrointestinal surgeries, and major morbidities following total gastrectomy can be serious and fatal. This study aimed to develop and validate preoperative risk models of morbidities associated with total gastrectomy using a Japanese web-based nationwide registry. METHODS: The national clinical database was used to retrieve the records of 39,253 patients who underwent total gastrectomy in 1,841 hospitals between January 1, 2011 and December 31, 2012...
March 11, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28282922/the-development-of-a-novel-therapeutic-strategy-to-target-hyaluronan-in-the-extracellular-matrix-of-pancreatic-ductal-adenocarcinoma
#16
REVIEW
Daisuke Kudo, Akiko Suto, Kenichi Hakamada
Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal diseases to affect humans, regardless of whether patients receive multimodal therapy (including surgery, radiotherapy, and chemotherapy). This resistance to intervention is currently considered to be caused by the desmoplastic change of the extracellular matrix (ECM) in PDAC tissues, which is characterized by the accumulation of cancer-associated fibroblasts, collagen, proteoglycan, and hyaluronan. Among these ECM components, hyaluronan has attracted interest because various studies have indicated that hyaluronan-rich PDAC is correlated with the progressive properties of cancer cells, both in experimental and clinical settings...
March 9, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28280624/the-concept-of-borderline-resectable-pancreatic-cancer-limited-foundations-and-limited-future
#17
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/28278438/diagnosis-of-autoimmune-pancreatitis-with-cholesterol-granuloma-mimicking-intraductal-papillary-mucinous-carcinoma-a-case-report
#18
Yusuke Takahashi, Naoyuki Yokoyama, Daisuke Sato, Tetsuya Otani, Koko Mitsuma, Hideki Hashidate
INTRODUCTION: Pancreatic cysts are often observed incidentally on abdominal computed tomography (CT). For cysts involving intracystic nodules, malignant neoplasms such as intraductal papillary-mucinous carcinoma (IPMC) should be suspected. In contrast, cholesterol granuloma (CG) rarely occurs in the pancreas, and CG-associated autoimmune pancreatitis (AIP) has not yet been reported. To our knowledge, this is the first reported case of AIP with CG mimicking IPMC. PRESENTATION OF CASE: A 56-year-old woman underwent abdominal CT for preoperative breast cancer screening...
March 1, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28272344/nutritional-and-metabolic-derangements-in-pancreatic-cancer-and-pancreatic-resection
#19
REVIEW
Taylor M Gilliland, Nicole Villafane-Ferriol, Kevin P Shah, Rohan M Shah, Hop S Tran Cao, Nader N Massarweh, Eric J Silberfein, Eugene A Choi, Cary Hsu, Amy L McElhany, Omar Barakat, William Fisher, George Van Buren
Pancreatic cancer is an aggressive malignancy with a poor prognosis. The disease and its treatment can cause significant nutritional impairments that often adversely impact patient quality of life (QOL). The pancreas has both exocrine and endocrine functions and, in the setting of cancer, both systems may be affected. Pancreatic exocrine insufficiency (PEI) manifests as weight loss and steatorrhea, while endocrine insufficiency may result in diabetes mellitus. Surgical resection, a central component of pancreatic cancer treatment, may induce or exacerbate these dysfunctions...
March 7, 2017: Nutrients
https://www.readbyqxmd.com/read/28270288/characteristics-of-ct-perfusion-parameters-of-focal-pancreatic-lesions-and-data-comparison-of-different-algorithms
#20
Ping Li, Liang Zhu, Huadan Xue, Changyi Liu, Kai Xu, Juan Li, Ting Sun, Zhengyu Jin
Objective To characterize the CT perfusion parameters of focal pancreatic lesions including pancreatic cancers (PACs) and pancreatic neuroendocrine tumors (pNETs),estimate the confirmity and fungibility of parameters obtained from Deconvolution and Maximum slope+Patlak.Methods From December 2015 to November 2016,22 patients with PACs and 22 patients with pNETs(37 lesions confirmed by surgery and biopsy)underwent preoperative whole-pancreas CT perfusion in our center. The volume perfusion CT of the entire pancreas was performed at 80 kV and 100 mA,using 28 consecutive volume measurements and intravenous injection of 45 ml of iodinated contrast and saline at a flow rate of 5 ml/s...
February 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
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