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Pancreatic cancer surgery

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https://www.readbyqxmd.com/read/29679211/surgery-after-folfirinox-treatment-for-locally-advanced-and-borderline-resectable-pancreatic-cancer-increase-in-tumour-attenuation-on-ct-correlates-with-r0-resection
#1
Giovanni Marchegiani, Valentina Todaro, Enrico Boninsegna, Riccardo Negrelli, Binit Sureka, Debora Bonamini, Roberto Salvia, Riccardo Manfredi, Roberto Pozzi Mucelli, Claudio Bassi
OBJECTIVES: To assess factors associated with radical resection (R0) of pancreatic ductal adenocarcinoma (PDAC) after induction treatment with FOLFIRINOX. METHODS: Patients with either locally advanced (LA) and borderline resectable (BR) PDAC undergoing surgical exploration after FOLFIRINOX were retrospectively enrolled. Two pancreatic radiologists reviewed the CT blinded to the final outcome and assessed chemotherapy response and resectability. Patients were then divided into R0 resected (group A) and not resected/R1 resected (group B), which were compared...
April 20, 2018: European Radiology
https://www.readbyqxmd.com/read/29674761/impact-of-body-mass-index-on-survival-of-pancreatic-cancer-patients-in-japan
#2
Tomohiro Okura, Masakuni Fujii, Junji Shiode, Yuri Ito, Toru Kojima, Junichiro Nasu, Takefumi Niguma, Masao Yoshioka, Tetsushige Mimura, Kazuhide Yamamoto
The impact of body mass index (BMI) on postoperative survival in Japanese patients with pancreatic cancer is unclear. We examined the relationship between preoperative BMI and the prognosis of Japanese patients who underwent surgery for pancreatic cancer to determine whether BMI affects these patients' prognosis. Of the patients who underwent pancreatectomy between January 2004 and August 2015 at our institution, 246 were pathologically diagnosed with pancreatic tubular adenocarcinoma; the cancer was located in the pancreatic head (n=161) and in the body and tail (n=85)...
April 2018: Acta Medica Okayama
https://www.readbyqxmd.com/read/29671537/chronic-pancreatitis-diagnosis-and-treatment
#3
Kathleen Barry
Chronic pancreatitis is an irreversible and progressive disorder of the pancreas characterized by inflammation, fibrosis, and scarring. Exocrine and endocrine functions are lost, often leading to chronic pain. The etiology is multifactorial, although alcoholism is the most significant risk factor in adults. The average age at diagnosis is 35 to 55 years. If chronic pancreatitis is suspected, contrast-enhanced computed tomography is the best imaging modality for diagnosis. Computed tomography may be inconclusive in early stages of the disease, so other modalities such as magnetic resonance imaging, magnetic resonance cholangiopancreatography, or endoscopic ultrasonography with or without biopsy may be used...
March 15, 2018: American Family Physician
https://www.readbyqxmd.com/read/29668669/pancreatic-neuroendocrine-neoplasms-a-role-of-laparoscopy-in-surgical-treatment-review
#4
Jacek Szeliga, Marek Jackowski
Pancreatic neuroendocrine neoplasms (PNENs) are extremely rare neoplasms of the pancreas. They originate from pancreatic islet cells, and from the very beginning, cancer cells may or may not show hormone hypersecretion. Currently, surgical treatment is the only therapeutic method that significantly prolongs life expectancy, and in such cases it is a method of choice. In the paper, a review of literature based on the Medline database and including mainly the period of 2013 to 2017 was performed. In each case an operating surgeon is responsible for selection of a method used for surgical treatment...
April 17, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/29667116/intraoperative-pancreatic-cancer-detection-using-tumor-specific-multimodality-molecular-imaging
#5
Willemieke S Tummers, Sarah E Miller, Nutte T Teraphongphom, Adam Gomez, Idan Steinberg, David M Huland, Steve Hong, Sri-Rajasekhar Kothapalli, Alifia Hasan, Robert Ertsey, Bert A Bonsing, Alexander L Vahrmeijer, Rutger-Jan Swijnenburg, Teri A Longacre, George A Fisher, Sanjiv S Gambhir, George A Poultsides, Eben L Rosenthal
BACKGROUND: Operative management of pancreatic ductal adenocarcinoma (PDAC) is complicated by several key decisions during the procedure. Identification of metastatic disease at the outset and, when none is found, complete (R0) resection of primary tumor are key to optimizing clinical outcomes. The use of tumor-targeted molecular imaging, based on photoacoustic and fluorescence optical imaging, can provide crucial information to the surgeon. The first-in-human use of multimodality molecular imaging for intraoperative detection of pancreatic cancer is reported using cetuximab-IRDye800, a near-infrared fluorescent agent that binds to epidermal growth factor receptor...
April 17, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29665327/adjuvant-radiotherapy-and-chemotherapy-improve-survival-in-patients-with-pancreatic-adenocarcinoma-receiving-surgery-adjuvant-chemotherapy-alone-is-insufficient-in-the-era-of-intensity-modulation-radiation-therapy
#6
Mao-Chih Hsieh, Wei-Wen Chang, Hsin-Hsien Yu, Chang-Yun Lu, Chia-Lun Chang, Jyh-Ming Chow, Shee-Uan Chen, Yunfeng Cheng, Szu-Yuan Wu
In the era of intensity modulation radiation therapy (IMRT), no prospective randomized trial has evaluated the efficacy of adjuvant therapies such as adjuvant concurrent chemoradiotherapy (CCRT), adjuvant sequential chemotherapy and radiotherapy (CT-RT), and adjuvant CT alone in resectable pancreatic adenocarcinoma (PA). Through propensity score matching, we designed a nationwide, population-based, head-to-head cohort study to determine the effects of dissimilar adjuvant treatments on resectable PA. We minimized the confounding of various adjuvant treatment outcomes among the following resectable PA groups of patients from the Taiwan Cancer Registry database: group 1, adjuvant CCRT; group 2, adjuvant sequential CT-RT; and group 3, adjuvant CT alone...
April 17, 2018: Cancer Medicine
https://www.readbyqxmd.com/read/29652026/preoperative-biliary-drainage-using-a-fully-covered-self-expandable-metallic-stent-for-pancreatic-head-cancer-a-prospective-feasibility-study
#7
Osamu Togawa, Hiroyuki Isayama, Hiroshi Kawakami, Yousuke Nakai, Dai Mohri, Tsuyoshi Hamada, Hirofumi Kogure, Kazumichi Kawakubo, Naoya Sakamoto, Kazuhiko Koike, Hiroto Kita
Background/Aims: The role of endoscopic preoperative biliary drainage (PBD) for pancreatic head cancer is controversial because of the high incidence of stent occlusion before surgery. This study was performed to evaluate the feasibility and safety of PBD using a fully covered self-expandable metallic stent (FCSEMS). Patients and Methods: This multicenter prospective study involved 26 patients treated for pancreatic head cancer with distal bile duct obstruction from April 2011 to March 2013...
April 13, 2018: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/29651809/development-of-chemotherapy-and-significance-of-conversion-surgery-after-chemotherapy-in-unresectable-pancreatic-cancer
#8
REVIEW
Junji Furuse, Junji Shibahara, Masanori Sugiyama
While surgery currently remains the only potentially curative treatment available for pancreatic cancer, only 20% to 30% of patients have resectable disease at diagnosis. Recently, with the introduction of intensive chemotherapy regimens such as oxaliplatin, irinotecan, fluorouracil plus leucovorin (FOLFIRINOX) and gemcitabine plus nab-paclitaxel, for the treatment of unresectable pancreatic cancer, the antitumor activity and overall survival in patients with pancreatic cancer have dramatically improved. These advances in intensive chemotherapy have led to the possibility of conversion of unresectable disease to resectable disease, and it has been reported that more than 20% of pancreatic cancer patients with unresectable locally advanced disease at diagnosis undergo successful conversion surgery after FOLFIRINOX therapy...
April 12, 2018: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/29650943/-a-useful-case-of-photodynamic-diagnosis-of-inferior-vena-cava-invasion-by-pancreatic-head-cancer-using-5-aminolevulinic-acid-5-ala
#9
Toru Mizutani, Yasutoshi Murayama, Hisashi Ikoma, Tomohiro Arita, Toshiyuki Kosuga, Hirotaka Konishi, Ryo Morimura, Atsushi Shiozaki, Yoshiaki Kuriu, Masayoshi Nakanishi, Hitoshi Fujiwara, Kazuma Okamoto, Eigo Otsuji
Curative resection is necessary to survival in pancreatic cancer, however after surgery, pathologic examination sometimes diagnoses the remains of cancer at the resected stump. Therefore, it is necessary to evaluate the stump by intraoperative rapid pathological examination. 5-aminolevulinic acid(5-ALA)is an endogenous natural amino acid and precursor of the heme pathway. 5-ALA is metabolized and accumulated as protoporphyrin IX(Pp IX)that is photosensitive substance. 5-ALA mediated photodynamic diagnosis(PDD)(ALA-PDD)has high diagnostic ability...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650931/-a-case-of-locally-advanced-pancreatic-cancer-successfully-resected-after-s-1-therapy-in-an-elderly-patient
#10
Shojirokazunori Ikenaga, Masaaki Endo, Masahiro Iwama, Motonari Ohashi, Makoto Yokoyama, Hiroyuki Jin, Tomomi Kusumi
We report a case of locally advanced pancreatic body cancer, accomplishing R0 resection following preoperative chemotherapy. An 80-year-old female patient was admitted to our hospital because of high CA19-9 levels.Based on computed tomography images, she was diagnosed with locally advanced cancer of the pancreatic body.We started S-1 chemotherapy (100mg/day, 2 weeks administration 1 week rest)because the tumor was suspected to have invaded the celiac trunk and the common hepatic artery.The tumor decreased in size, and the encasement of the celiac trunk and the common hepatic artery were released, following 6 months of chemotherapy...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650926/-a-resected-case-of-adenosquamous-carcinoma-of-pancreas-that-relapsed-in-remnant-pancreas
#11
Kotaro Miura, Akishige Kanazawa, Sadatoshi Shimizu, Akihiro Murata, Shintaro Kodai, Takafumi Nishii, Katsunobu Sakurai, Akiko Tachimori, Yutaka Tamamori, Naoshi Kubo, Toru Inoue, Yukio Nishiguchi
A 70's man underwent subtotal stomach preserving pancreatoduodenectomy(SSPPD)for pancreatic head cancer. The pathological diagnosis was adenosquamous carcinoma(ASC)of the pancreas. Two months after surgery, a recurrent tumor in the remnant pancreas was confirmed with a CT scan and suspected to be ASC by endoscopic ultrasound-guided fine needle aspiration(EUS-FNA). As the recurrent lesion was limited in the pancreas, total remnant pancreatectomy(TP)was performed 4 months after SSPPD. The final pathological diagnosis was ASC...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650856/-a-case-of-performed-right-colectomy-with-pancreato-duodenectomy-for-transverse-colon-cancer-invased-to-duodenum
#12
Ryutaro Udo, Masanobu Enomoto, Kazushige Tsurui, Yuu Kuboyama, Hiroshi Kuwabara, Masatoshi Shigoka, Tetsuo Ishizaki, Kenji Katsumata, Hiyo Obikane, Akihiko Tsuchida
There is a clear consensus regarding the combined resection of organs with cancer invasion, patients with colon cancer. However, there are very few reports to our knowledge regarding the use of pancreato-duodenectomy(PD)for colon cancer patients with cancer invasion in the duodenum. We here report a colon cancer patient in whom we performed PD and right hemicolectomy, who showed favorable results with no recurrence. The patient was a 69-year-old woman. Her chief complaint was hypogastric pain. Her previous doctor performed colonoscopy and a colonoscopic biopsy, and detected a type 2 lesion, throughout the entire circumference of the transverse colon near the liver, and she was diagnosed with adenocarcinoma...
April 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29629335/intraoperative-radiation-boost-to-the-surgical-resection-bed-following-pancreaticoduodenectomy-for-a-borderline-resectable-pancreatic-carcinoma-a-case-report
#13
Tarita O Thomas, William Small, Mark Fleming, Song Kang, Richard A Hoefer
Neoadjuvant therapy including chemotherapy alone or concurrent chemotherapy with external bream radiation is a standard treatment strategy for borderline resectable pancreatic adenocarcinoma and is also used routinely for primary operable cancers at some institutions (1). The use of intraoperative radiation therapy (IORT) has been limited largely because of the logistical issues in delivery of radiation during surgery (2). This is the first reported case of a borderline resectable pancreas cancer patient who underwent neoadjuvant chemo-radiation therapy followed by resection with the use of IORT using the mobile IntraBeam device to boost the resection bed and improve local control by dose escalation...
2018: Frontiers in Oncology
https://www.readbyqxmd.com/read/29627496/simvastatin-inhibits-sonic-hedgehog-signaling-and-stemness-features-of-pancreatic-cancer
#14
Yefeng Yin, Li Liu, Zhefu Zhao, Libo Yin, Nathalie Bauer, Clifford C Nwaeburu, Jury Gladkich, Wolfgang Gross, Thilo Hackert, Carsten Sticht, Norbert Gretz, Oliver Strobel, Ingrid Herr
Pancreatic ductal adenocarcinoma (PDA) has poor therapeutic options. Recent patient studies indicate that cholesterol-lowering statins have anti-tumor capacities. We examined several established and primary PDA and normal cell lines as well as PDA patient tissues (n = 68). We found that simvastatin inhibited viability, stemness, tumor growth and metastasis and that it enhanced the efficacy of gemcitabine. These changes were associated with modulation of Shh-related gene expression. Overexpression of Shh prevented the anti-cancer effect of simvastatin, and inhibition of Shh mimicked the simvastatin effect...
April 5, 2018: Cancer Letters
https://www.readbyqxmd.com/read/29616107/awareness-of-hepatic-arterial-variants-is-required-in-surgical-oncology-decision-making-strategy-case-report-and-review-of-literature
#15
Robert Sitarz, Monika Berbecka, Jerzy Mielko, Karol Rawicz-Pruszyński, Grzegorz Staśkiewicz, Ryszard Maciejewski, Wojciech Polkowski
Surgery for the treatment of pancreatic cancer remains the gold standard, however, the identification of the vascular supply of the pancreas and the nearby organs remains a crucial difficulties in a curative resection. During pancreatic head resection for carcinoma dissection of regional arterial vasculature is mandatory. Normal coeliac and hepatic arterial anatomy occurs in ~50-70% of patients and multiple variations have been described. Knowledge of multiple arterial anomalies is essential in hepato-pancreatico-billary surgery to avoid unnecessary complications...
May 2018: Oncology Letters
https://www.readbyqxmd.com/read/29610022/complications-and-their-correlation-with-prognosis-in-patients-undergoing-total-gastrectomy-with-splenectomy-for-treatment-of-proximal-advanced-gastric-cancer
#16
Masahiro Watanabe, Takahiro Kinoshita, Masanori Tokunaga, Akio Kaito, Shizuki Sugita
INTRODUCTION: Spleen-preserving surgery is a mainstay in the treatment of proximal advanced gastric cancer according to the results of several clinical studies. However, total gastrectomy with splenectomy (TGS) still plays a role in the treatment of aggressive tumors invading the greater curvature line or adjacent structures, in spite of its high morbidity. The aim of this study was to identify the risk factors for morbidity and the association between the occurrence of postoperative complications and long-term outcomes...
March 23, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29605904/three-dimensional-computer-assisted-dissection-of-pancreatic-lymphatic-anatomy-on-human-fetuses-a-step-toward-automatic-image-alignment
#17
T Bardol, G Subsol, M-J Perez, D Genevieve, A Lamouroux, B Antoine, G Captier, M Prudhomme, M M Bertrand
PURPOSE: Pancreatic cancer is the fourth cause of death by cancer worldwide. Lymph node (LN) involvement is known to be the main prognostic factor. However, lymphatic anatomy is complex and only partially characterized. The aim of the study was to study the pancreatic lymphatic system using computer-assisted anatomic dissection (CAAD) technique and also to update CAAD technique by automatizing slice alignment. METHODS: We dissected three human fetuses aged from 18 to 34 WA...
March 31, 2018: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29604352/pancreaticoduodenectomy-is-justified-in-a-subset-of-elderly-patients-with-pancreatic-ductal-adenocarcinoma-a-population-based-retrospective-cohort-study-of-4-283-patients
#18
Lili Lu, Xianbin Zhang, Guanglin Tang, Yuru Shang, Peng Liu, Yushan Wei, Peng Gong, Li Ma
BACKGROUND: The survival benefit of pancreaticoduodenectomy (PD) in elderly patients with pancreatic ductal adenocarcinoma (PDAC) is still unclear. METHODS: Data pertaining to elderly (age ≥75 years) and younger (age <75 years) patients with potentially curable PDAC who underwent pancreaticoduodenectomy in the period 2004-2013 were extracted from the Surveillance, Epidemiology, and End Results database. The Cox proportional hazards model and stratified Kaplan-Meier survival analyses were performed...
March 28, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29602820/dual-modality-immunopet-and-near-infrared-fluorescence-nirf-imaging-of-pancreatic-cancer-using-an-anti-prostate-cancer-stem-cell-antigen-psca-cys-diabody
#19
Kirstin A Zettlitz, Wen-Ting K Tsai, Scott M Knowles, Naoko Kobayashi, Timothy R Donahue, Robert E Reiter, Anna M Wu
Pancreatic cancer has a high mortality rate due to late diagnosis and the tendency to invade surrounding tissues and metastasize at an early stage. A molecular imaging agent that enables both pre-surgery antigen-specific positron emission tomography (immunoPET) and intra-operative near-infrared fluorescent (NIRF)-guidance could benefit diagnosis, staging and surgical resection of pancreatic cancer, which remains the only curative treatment. Methods: A dually labeled probe was developed based on A2 cys-diabody (A2cDb) targeting the cell surface antigen prostate stem cell antigen (PSCA) that is expressed in a majority of pancreatic cancers...
March 30, 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/29600432/catheter-probe-extraductal-ultrasound-edus-exploration-of-the-common-bile-duct-is-safe-in-elderly-patients-with-suspicion-of-choledocholithiasis-after-distal-gastrectomy
#20
Thomas Togliani, Stefano Pilati, Andrea Lisotti, Giancarlo Caletti, Pietro Fusaroli
PURPOSE: Post-surgical upper gastrointestinal anatomy may hamper a complete bilio-pancreatic evaluation with a standard echoendoscope. The aim of this study was to assess the role of catheter probe extraductal ultrasound (EDUS) for the evaluation of the common bile duct (CBD) in patients who are status post-gastric surgery and who are suspected of having choledocholithiasis. METHODS: We retrospectively analyzed patients with a prior history of gastric surgery, who underwent EDUS for a suspicion of CBD obstruction...
March 29, 2018: Abdominal Radiology
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