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Pancreatic cancer surgery

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https://www.readbyqxmd.com/read/27909037/safety-and-efficacy-of-stereotactic-body-radiation-therapy-combined-with-s-1-simultaneously-followed-by-sequential-s-1-as-an-initial-treatment-for-locally-advanced-pancreatic-cancer-silapanc-trial-study-design-and-rationale-of-a-phase-ii-clinical-trial
#1
Xiaofei Zhu, Xiaoping Ju, Fei Cao, Fang Fang, Shuiwang Qing, Yuxin Shen, Zhen Jia, Yangsen Cao, Huojun Zhang
INTRODUCTION: Upfront surgeries are not beneficial to most patients with pancreatic cancer. Therefore, more emphasis has been placed chemoradiotherapy in locally advanced pancreatic cancer recently. Gemcitabine-based regimens or FOLFIRINOX (a chemotherapy regimen including leucovorin, 5-FU, irinotecan, oxaliplatin) has been proven as a standard chemotherapy in pancreatic cancer. However, severe toxicities may prevent the completion of chemotherapy. S-1 has showed better objective response rates, similar overall survival rates and progression-free survival rates compared with gemcitabine, revealing that S-1 may be a potential candidate in treating pancreatic cancer, especially for patients refractory to gemcitabine...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27905367/-celiac-trunk-resection-in-patients-with-pancreatic-cancer-and-severe-pain-syndrome
#2
Yu I Patyutko, M G Abgaryan, N E Kudashkin, A G Kotel'nikov
AIM: To show the advisability, satisfactory tolerance and good analgesic effect of surgery for pancreatic ductal carcinoma with celiac trunk invasion. MATERIAL AND METHODS: Distal subtotal pancreatectomy with resection of celiac trunk and common hepatic artery was made in 21 patients. RESULTS: Early postoperative complications after distal subtotal pancreatectomy with celiac trunk resection occurred in 10 (47.6%) patients. There was no postoperative mortality...
2016: Khirurgiia
https://www.readbyqxmd.com/read/27896658/poor-glycemic-control-is-associated-with-failure-to-complete-neoadjuvant-therapy-and-surgery-in-patients-with-localized-pancreatic-cancer
#3
E S Paul Rajamanickam, K K Christians, M Aldakkak, A N Krepline, P S Ritch, B George, B A Erickson, W D Foley, M Aburajab, D B Evans, S Tsai
BACKGROUND: The impact of glycemic control in patients with pancreatic cancer treated with neoadjuvant therapy is unclear. METHODS: Glycated hemoglobin (HbA1c) values were measured in patients with localized pancreatic cancer prior to any therapy (pretreatment) and after neoadjuvant therapy prior to surgery (preoperative). HbA1c levels greater than 6.5% were classified as abnormal. Patients were categorized based on the change in HbA1c levels from pretreatment to preoperative: GrpA, always normal; Gr B, worsened; GrpC, improved; and GrpD, always abnormal...
November 28, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27896637/seom-clinical-guideline-for-the-treatment-of-pancreatic-cancer-2016
#4
R Vera, E Dotor, J Feliu, E González, B Laquente, T Macarulla, E Martínez, J Maurel, M Salgado, J L Manzano
Pancreatic cancer remains an aggressive disease with a 5 year survival rate of 5%. Only 15% of patients with pancreatic cancer are eligible for radical surgery. Evidence suggests a benefit on survival with adjuvant chemotherapy (gemcitabine o fluourouracil) after R1/R0 resection. Adjuvant chemoradiotherapy is also a valid option in patients with positive margins. Borderline resectable pancreatic cancer is defined as the involvement of the mesenteric vasculature with a limited extension. These tumors are technically resectable, but with a high risk of positive margins...
November 28, 2016: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/27891190/cell-free-dna-promoter-hypermethylation-in-plasma-as-a-diagnostic-marker-for-pancreatic-adenocarcinoma
#5
Stine Dam Henriksen, Poul Henning Madsen, Anders Christian Larsen, Martin Berg Johansen, Asbjørn Mohr Drewes, Inge Søkilde Pedersen, Henrik Krarup, Ole Thorlacius-Ussing
BACKGROUND: Pancreatic cancer has a 5-year survival rate of only 5-7%. Difficulties in detecting pancreatic cancer at early stages results in the high mortality and substantiates the need for additional diagnostic tools. Surgery is the only curative treatment and unfortunately only possible in localized tumours. A diagnostic biomarker for pancreatic cancer will have a major impact on patient survival by facilitating early detection and the possibility for curative treatment. DNA promoter hypermethylation is a mechanism of early carcinogenesis, which can cause inactivation of tumour suppressor genes...
2016: Clinical Epigenetics
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
#6
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...
November 25, 2016: Acta Oncologica
https://www.readbyqxmd.com/read/27882472/the-role-of-venous-and-arterial-resection-in-pancreatic-cancer-surgery
#7
Gyulnara G Kasumova, W Charles Conway, Jennifer F Tseng
Pancreatic cancer continues to carry a dismal prognosis with the majority of patients presenting at advanced stages of disease. Complete surgical resection remains essential for prolonging survival and increasing the possibility of cure. However, few patients will be resectable at diagnosis, with a significant portion presenting with borderline or locally advanced disease. The addition of vascular resection and reconstruction at the time of pancreatectomy enables expansion of the patient population able to undergo resection with curative intent and achieve tumor-free margins...
November 23, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27879141/-complete-mesocolic-excision-during-right-hemicolectomy
#8
V Procházka, A Zetelová, T Grolich, L Frola, Z Kala
INTRODUCTION: Complete mesocolic excision (CME) ensures the removal of all sentinel and regional lymph nodes during colon cancer surgery. For right-sided hemicolectomy it is essential to dissect the wall of vena mesenterica superior, which increases the risk of injuring surrounding organs. So far, no randomized studies comparing long-term oncological results of standard right hemicolectomy and hemicolectomy with CME have been published. METHOD: 83 patients operated for colon carcinoma in 2014 and 2015 were included in this study, all of them undergoing right-sided hemicolectomy using laparotomy access...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/27879138/-total-pancreatectomy-for-pancreatic-malignancy-from-history-to-the-present-day
#9
M Ryska, J Rudiš
Currently, total pancreatectomy (TP) is indicated in approximately one in ten surgical patients with pancreatic cancer. Key role in the decision falls in the competence of the multidisciplinary team, alternatively of the surgeon in the intraoperative period in some cases. Exceptionally, TP is approached in the so-called salvage surgery. Perioperative mortality of TP as an elective procedure does not exceed that of partial resections; however, mortality of up to 50% is associated with salvage surgery in acute postoperative pancreatitis...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/27875849/-short-and-long-term-results-in-operable-pancreatic-ductal-adenocarcinomas-from-a-cooperation-between-two-departments-gastroenterology-visceral-surgery-at-non-university-hospitals-benchmarked-to-results-of-expert-centers
#10
W Dippold, V Sivanathan, K Statt, M Roitman, K H Link
The only curative approach in pancreatic ductal adenocarcinoma (PDAC) is resection, which is possible only in 15 - 30 % of patients. Local tumor spread or distant metastases are contraindications for resection in the majority of patients. Surgical-oncological quality with short- and long-term results are varying tremendously, so that "expertise/quality" are associated to hospital- or surgeon's volume and/or center formation. The treatment results also depend, to a great extent, on the medical diagnostic quality...
November 22, 2016: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27865281/definition-and-management-of-borderline-resectable-pancreatic-cancer
#11
REVIEW
Jason W Denbo, Jason B Fleming
Patients with localized pancreatic ductal adenocarcinoma seek potentially curative treatment, but this group represents a spectrum of disease. Patients with borderline resectable primary tumors are a unique subset whose successful therapy requires a care team with expertise in medical care, imaging, surgery, medical oncology, and radiation oncology. This team must identify patients with borderline tumors then carefully prescribe and execute a combined treatment strategy with the highest possibility of cure...
December 2016: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27865278/adjuvant-and-neoadjuvant-therapy-for-resectable-pancreatic-and-periampullary-cancer
#12
REVIEW
Stephanie M Kim, Jennifer R Eads
Pancreatic adenocarcinoma is a relatively uncommon malignancy associated with a high rate of cancer-related mortality despite best efforts to perform curative surgery. Adjuvant therapy in patients after surgical resection is associated with improved overall survival. Adjuvant treatment approaches may include either chemotherapy alone or a combination of chemotherapy and radiation therapy. Neoadjuvant approaches, also including either chemotherapy alone or a combination of chemotherapy and radiation therapy, are under investigation...
December 2016: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27865277/surgical-therapy-for-pancreatic-and-periampullary-cancer
#13
REVIEW
John B Ammori, Kevin Choong, Jeffrey M Hardacre
Surgery is the key component of treatment for pancreatic and periampullary cancers. Pancreatectomy is complex, and there are numerous perioperative and intraoperative factors that are important for achieving optimal outcomes. This article focuses specifically on key aspects of the surgical management of periampullary and pancreatic cancers.
December 2016: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27864333/oncogenic-kras-targets-muc16-ca125-in-pancreatic-ductal-adenocarcinoma
#14
Xianjun Yu, Chen Liang, Yi Qin, Bo Zhang, Shunrong Ji, Si Shi, Wenyan Xu, Jiang Liu, Jin-Feng Xiang, Dingkong Liang, Qiangsheng Hu, Quanxing Ni, Jin Xu
: Pancreatic ductal adenocarcinoma (PDAC) is a devastating disease with the 5-year survival rate less than 6%. Previous results indicated that serum levels of CA125 (encoded by MUC16) could be used to predict which groups of pancreatic cancer patients may benefit from surgery. However, the underlying mechanism remains elusive. Herein, using the Cancer Genome Atlas (TCGA) and clinicopathological data obtained from our center, we demonstrate that high CA125 serum levels and expression levels of MUC16 are predictive of poor prognosis...
November 18, 2016: Molecular Cancer Research: MCR
https://www.readbyqxmd.com/read/27859270/impact-of-pancreatectomy-on-long-term-patient-reported-symptoms-and-quality-of-life-in-recurrence-free-survivors-of-pancreatic-and-periampullary-neoplasms
#15
Jordan M Cloyd, Hop S Tran Cao, Maria Q B Petzel, Jason W Denbo, Nathan H Parker, Graciela M Nogueras-González, Joseph S Liles, Michael P Kim, Jeffrey E Lee, Jean-Nicolas Vauthey, Thomas A Aloia, Jason B Fleming, Matthew H G Katz
BACKGROUND: Long term patient-reported symptoms and quality of life (QOL) are important outcome metrics following cancer operations, but have been poorly described in patients who have previously undergone pancreatectomy. METHODS: We conducted a cross-sectional survey of recurrence-free survivors of pancreatic ductal adenocarcinoma, periampullary carcinomas, and pancreatic neuroendocrine tumors who had undergone prior pancreatectomy. QOL and symptom burden were measured using the Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire, and psychosocial distress was measured using the Hospital Anxiety and Depression Scale...
November 11, 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27858562/multimodality-therapy-in-patients-with-borderline-resectable-or-locally-advanced-pancreatic-cancer-importance-of-locoregional-therapies-for-a-systemic-disease
#16
Susan Tsai, Kathleen K Christians, Paul S Ritch, Ben George, Abdul H Khan, Beth Erickson, Douglas B Evans
Historically, the clinical staging of pancreatic cancer has centered on the surgical management of the primary tumor, because few effective chemotherapeutic agents were available and long-term survival was only achieved in the context of surgical resection. Such a strategy of complete oncologic surgical care is reasonable when surgery is both the principal therapy and highly effective. However, complex surgery for pancreatic cancer-often performed in older patients after a lengthy period of induction therapy-can be associated with significant morbidity and mortality...
October 2016: Journal of Oncology Practice
https://www.readbyqxmd.com/read/27858118/utility-of-amplatzer-vascular-plug-with-preoperative-common-hepatic-artery-embolization-for-distal-pancreatectomy-with-en-bloc-celiac-axis-resection
#17
Masafumi Toguchi, Masakatsu Tsurusaki, Isao Numoto, Syojiro Hidaka, Miho Yamakawa, Nobuyuki Asato, SungWoon Im, Yukinobu Yagyu, Mitsuru Matsuki, Yoshifumi Takeyama, Takamichi Murakami
PURPOSE: To evaluate the feasibility and safety of the Amplatzer vascular plug (AVP) for preoperative common hepatic embolization (CHA) before distal pancreatectomy with en bloc celiac axis resection (DP-CAR) to redistribute blood flow to the stomach and liver via the superior mesenteric artery (SMA). MATERIALS AND METHODS: Four patients (3 males, 1 female; median age 69 years) with locally advanced pancreatic body cancer underwent preoperative CHA embolization with AVP...
November 17, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27856064/radical-surgery-of-oligometastatic-pancreatic-cancer
#18
T Hackert, W Niesen, U Hinz, C Tjaden, O Strobel, A Ulrich, C W Michalski, M W Büchler
BACKGROUND: In metastatic disease (M1), chemotherapy (expected survival: 6-10 months) is considered the only treatment option. The aim of this study was to evaluate the outcome of curative M1 PDAC resections. METHODS: Prospective data of all patients undergoing primary tumour and metastasis resection for stage IV PDAC during a 12-year period was analysed regarding localisation (liver or distant interaortocaval lymph nodes; ILN), morbidity and survival. Patients were stratified with regard to syn- or metachronous metastases resection...
November 9, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27855353/challenging-the-limits-in-pancreatic-surgery-a-case-report
#19
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...
November 14, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27847403/pancreatic-cancer-80-years-of-surgery-percentage-and-repetitions
#20
REVIEW
Birgir Gudjonsson
Objective. The incidence of pancreatic cancer is estimated to be 48,960 in 2015 in the US and projected to become the second and third leading causes of cancer-related deaths by 2030. The mean costs in 2015 may be assumed to be $79,800 per patient and for each resection $164,100. Attempt is made to evaluate the results over the last 80 years, the number of survivors, and the overall survival percentage. Methods. Altogether 1230 papers have been found which deal with resections and reveal survival information...
2016: HPB Surgery: a World Journal of Hepatic, Pancreatic and Biliary Surgery
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