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Pancreatic cancer surgery

Bing Liu, Max Heckler, Ulrike Heger, Susanne Roth, Ulla Klaiber, Markus W Büchler, Oliver Strobel, Christoph W Michalski, Thilo Hackert
BACKGROUND: The number of lymph nodes to be resected in surgery for non-pancreatic periampullary cancer remains unclear. METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was used to gather information from a large retrospective cohort. To define a novel, reasonable cut-off associated with survival, we stratified patients into subgroups depending on the number of resected lymph nodes. RESULTS: 1481 nodal-negative patients resected for periampullary cancer (excluding pancreatic ductal adenocarcinoma) were included...
June 19, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Yi-Nan Shen, Xue-Li Bai, Gang Jin, Qi Zhang, Jun-Hua Lu, Ren-Yi Qin, Ri-Sheng Yu, Yao Pan, Ying Chen, Pei-Wei Sun, Cheng-Xiang Guo, Xiang Li, Tao Ma, Guo-Gang Li, Shun-Liang Gao, Jian-Ying Lou, Ri-Sheng Que, Wan Y Lau, Ting-Bo Liang
BACKGROUND: Pancreatic head adenocarcinoma is commonly diagnosed at an advanced stage when adjacent vascular invasion is present. This study aimed to establish a preoperative prognostic nomogram for patients who underwent attempted curative resectional surgery for pancreatic head cancer with suspected peripancreatic venous invasion. METHODS: Data on all consecutive patients were retrospectively collected from 2012 to 2016 at four academic institutions. The demographic and radiological parameters were analyzed using univariate and multivariate Cox regression analyses...
June 19, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Maria Q B Petzel, Leah Hoffman
With slowly increasing survival rates in pancreatic cancer and international consensus guidelines recommending surgical resection of premalignant lesions, survival post-pancreatic resection is increasing. With longer survival time, the significant comorbidities of such major surgery have far-reaching effects on the nutrition status of the survivor of pancreatic cancer. This review describes the many nutrition-related side effects of pancreatic surgery, including the development of pancreatic enzyme insufficiency, micronutrient deficiencies, diabetes, fatty liver, and metabolic bone disease...
October 2017: Nutrition in Clinical Practice
Shizuma Omote, Katsuyoshi Takata, Takehiro Tanaka, Tomoko Miyata-Takata, Yoshiyuki Ayada, Mai Noujima-Harada, Rika Omote, Tetsuya Tabata, Yasuharu Sato, Tatsuya Toyokawa, Hironari Kato, Takahito Yagi, Hiroyuki Okada, Tadashi Yoshino
Pancreatic cancer has a poor prognosis; hence, novel prognostic markers and effective therapeutic targets should be identified. We aimed to evaluate folate receptor alpha (FR-α) expression in pancreatic cancer and examine its association with clinicopathological features. We utilized tissue samples from 100 primary pancreatic cancer patients who underwent surgery. FR-α was expressed in 37 of 100 cases (37%). The FR-α-positive group (median, 18.8 months) had a significantly poorer prognosis than the FR-α-negative group [median 21...
June 20, 2018: Medical Molecular Morphology
Jinming Yu, Zhaoyan Ding, Yuanming Yang, Shanli Liu
Several studies reported platelet-to-lymphocytes ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) were associated with the mid-term survival or cancer stage in pancreatic cancer. However, the relationship between these markers and the long-term prognosis of pancreatic cancer is still unknown. We investigated the relationship between PLR, NLR, RDW, and the long-term prognosis of pancreatic cancer.We included 182 pancreatic cancer patients who received operation at Linzi District People 's Hospital between August 2010 and January 2017...
June 2018: Medicine (Baltimore)
Lisa Dunleavy, Ahmed Al-Mukhtar, Vanessa Halliday
BACKGROUND: For those diagnosed with pancreatic cancer, ill-addressed pancreatic exocrine insufficiency (PEI) following surgery can result in malnutrition related complications that may impact on predict mortality and morbidity. The use of pancreatic enzyme replacement therapy (PERT) is recommended and often demands a degree of patient self-management. Understanding more about how this treatment is managed is fundamental to optimising care. OBJECTIVE: This study aimed to explore patient self-management of PERT following surgery for pancreatic cancer...
August 2018: Clinical Nutrition ESPEN
Stephen J Marx
Introduction: Multiple endocrine neoplasia type 1 (MEN1) is complex with regard to clinical expressions, management, and molecular pathways. Advances are being made broadly and in focused aspects. Selected topics are presented for their developments since publication of the most recent MEN1 consensus guidelines 6 years ago. Methods: Topics were selected for clinical impact or broad interest or both. For each topic, information was obtained from original reports and reviews...
April 1, 2018: Journal of Clinical Endocrinology and Metabolism
Andrea Boni, Giovanni Cochetti, Stefano Ascani, Michele Del Zingaro, Francesca Quadrini, Alessio Paladini, Diego Cocca, Ettore Mearini
BACKGROUND: The management of metastatic Renal Cell Carcinoma (RCC) has changed dramatically in the last 20 years, and the role of surgery in the immunotherapy's era is under debate. Metastatic lesions interesting pancreas are infrequent, but those harbouring from RCC have an high incidence. If metachronous resections are not rare, synchronous resection of primary RCC and its pancreatic metastasis is uncommonly reported, and accounts for a bad prognosis. CASE PRESENTATION: We report the case of a 68 years old woman, who presented hematuria at hospital incoming, with radiological appearance of a 13 cm left renal mass, with a 2...
June 13, 2018: BMC Surgery
Willemieke S Tummers, Juergen K Willmann, Bert A Bonsing, Alexander L Vahrmeijer, Sanjiv S Gambhir, Rutger-Jan Swijnenburg
Pancreatic ductal adenocarcinoma (PDAC) has a dismal prognosis. To improve outcomes, there is a critical need for improved tools for detection, accurate staging, and resectability assessment. This could improve patient stratification for the most optimal primary treatment modality. Molecular imaging, used in combination with tumor-specific imaging agents, can improve established imaging methods for PDAC. These novel, tumor-specific imaging agents developed to target specific biomarkers have the potential to specifically differentiate between malignant and benign diseases, such as pancreatitis...
July 2018: Pancreas
J Enrique Dominguez-Muñoz
PURPOSE OF REVIEW: Pancreatic exocrine insufficiency (PEI), defined as a secretion of pancreatic enzymes and bicarbonate insufficient to maintain a normal digestion, is a frequent but frequently underdiagnosed and undertreated condition. PEI may be secondary to different pancreatic diseases and extrapancreatic conditions. Recent data support the high clinical relevance of PEI and its treatment. RECENT FINDINGS: Together with symptoms of maldigestion, PEI is associated with nutritional deficiencies leading to osteoporosis, low-trauma fractures, sarcopenia and increased mortality...
June 7, 2018: Current Opinion in Gastroenterology
Sang Hyun Shin, Song Cheol Kim, Ki-Byung Song, Dae Wook Hwang, Jae Hoon Lee, Kwang-Min Park, Young-Joo Lee
BACKGROUND: To identify chronologic changes in clinical and survival features of pancreatic ductal adenocarcinoma based on diagnosis and treatment strategy development since 2000. METHODS: Among 2,029 patients enrolled in this study, 746 and 1,283 were treated between 2000 and 2009 (group 1) and between 2010 and 2016 (group 2), respectively. We used patient clinicopathologic, biologic, and molecular factors to assess the prognostic factors. RESULTS: Group 2 had a better survival outcome than group 1 (median survival time: 24...
June 5, 2018: Surgery
Ryosuke Yamaga, Koji Tezuka, Shuichiro Sugawara, Toshihiro Watanabe, Ichiro Hirai, Tamio Suzuki, Wataru Kimura
BACKGROUND: Metastatic recurrence after resection of pancreatic cancer is considered to be an incurable disease, and discoid lupus erythematosus (DLE)-like lesions are known as a side effect of fluorouracil agents. We report a very rare case of metastatic recurrence of pancreatic cancer in a Japanese man with DLE-like lesions in which long-term complete response was achieved through S-1 monotherapy. CASE PRESENTATION: A 65-year-old man who had undergone distal pancreatectomy with splenectomy for pancreatic body cancer and had received adjuvant gemcitabine developed postoperative para-aortic lymph node recurrence 17 months after surgery...
June 7, 2018: Surgical Case Reports
Hiroaki Miyake, Koji Murono, Kazushige Kawai, Keisuke Hata, Toshiaki Tanaka, Takeshi Nishikawa, Kensuke Otani, Kazuhito Sasaki, Manabu Kaneko, Shigenobu Emoto, Hiroaki Nozawa
AIM: Surgery for colorectal cancer located in the splenic flexure is difficult to perform because of the complex anatomy. Recently, in addition to the middle colic and left colic arteries (LCA), the accessory middle colic artery (AMCA) has been recognized as a feeding artery for the left-sided colon. This study aimed to evaluate the vascular anatomy of the splenic flexure focusing on the AMCA in a large number of patients. METHOD: A total of 734 patients who underwent computed tomography (CT) before surgery for colorectal cancer were enrolled...
June 7, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Philippe Bulens, Melissa Thomas, Christophe M Deroose, Karin Haustermans
Radiotherapy is the standard of care in the multimodality treatment of a variety of gastrointestinal (GI) tumours, such as oesophageal cancer, gastric cancer, rectal cancer and anal cancer. Additionally, radiotherapy has served as an alternative for surgery in patients with liver cancer, cancer of the biliary tract and pancreatic cancer. Positron-emission tomography (PET), generally in combination with computed tomography (CT), has an established role in the diagnosis, response assessment and (re-)staging of several GI tumours...
June 4, 2018: Quarterly Journal of Nuclear Medicine and Molecular Imaging
Darren D Ballard, Syed Rahman, Brian Ginnebaugh, Abdul Khan, Kulwinder S Dua
Background and study aims:  Durable biliary drainage is essential during neoadjuvant therapy (NAT) in patients with pancreatic cancer who present with biliary obstruction. Plastic stents (PS) tend to occlude readily, resulting in delay/interruption of treatment. Our aim was to evaluate the safety and efficacy of self-expanding metal stents (SEMS) for biliary drainage in patients receiving NAT for pancreatic cancer. Patients and methods:  From 2009 to 2014, all consecutive patients with resectable pancreatic cancer at one tertiary center had SEMS placed for biliary drainage before NAT was started...
June 2018: Endoscopy International Open
Célia Cintas, Thibaut Douché, Nicole Therville, Silvia Arcucci, Fernanda Ramos-Delgado, Céline Basset, Benoît Thibault, Julie Guillermet-Guibert
For patients with metastatic pancreatic cancer that are not eligible for surgery, signal-targeted therapies have so far failed to significantly improve survival. These therapeutic options have been tested in phase II/III clinical trials mostly in combination with the reference treatment gemcitabine. Innovative therapies aim to annihilate oncogenic dependency, or to normalize the tumoural stroma to allow immune cells to function and/or re-vascularisation to occur. Large scale transcriptomic and genomic analysis revealed that pancreatic cancers display great heterogeneity but failed to clearly delineate specific oncogene dependency, besides oncogenic Kras...
June 1, 2018: Cancers
Ziyu Han, Wenting Shang, Xiaoyuan Liang, Hao Yan, Min Hu, Li Peng, Hongmei Jiang, Chihua Fang, Kun Wang, Jie Tian
PURPOSE: Pancreatic cancer is still associated with a poor outcome and low patient quality of life, which are mainly attributed to the late detection and requirement of distal pancreatectomy with extended resection of pancreatic tumors. Therefore, novel strategies for early screening and precise tumor resection are urgently needed. In this study, we evaluated the feasibility of a low-density lipoprotein receptor (LDLR)-targeted small-molecule contrast agent (peptide-22-Cy7) for early screening with photoacoustic tomography and near-infrared (NIR) imaging as guided surgical navigation to achieve precise resection...
June 1, 2018: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
Abhishek Bhurwal, Muhammad Masoodul Haq, Sunil Sapru, Matthew Tortora, Dhanasekaran Ramasamy
Isolated pancreatic tuberculosis is an exceedingly rare condition, even in areas of the world where the disease is highly prevalent. Abdominal tuberculosis is a common form of extrapulmonary tuberculosis but involvement of the pancreas is very rare. We report a case of isolated pancreatic tuberculosis presenting as a pancreatic mass in a patient with persistent abdominal pain and jaundice. Clinically and radiologically, the mass mimicked a malignant pancreatic tumor with a vastly different prognostic implication and therapeutic approach...
2018: Case Reports in Gastrointestinal Medicine
Francesco D'Amico, Michele Finotti, Chiara Di Renzo, Alessio Pasquale, Alessandra Bertacco, Giorgio Caturegli, Gabriel E Gondolesi, Umberto Cillo
Pancreatic intraductal papillary-mucinous neoplasm is a rare primary neoplasm of unknown pathogenesis. This kind of tumor represents 0.2-2.7% of all pancreatic cancers and they may proceed to malignant lesions. In this study, we describe a case of pancreatic intraductal papillary-mucinous tumor (4.3 cm) with normal tumoral markers and nuclear atypia. We perform also a systematic review of the literature on MEDLINE and find only one relevant study that used microwave ablation for the palliative treatment of pancreatic tumor...
2018: Case Reports in Gastrointestinal Medicine
Yasuo Ohashi, Masataka Ikeda, Hideo Kunitoh, Mitsuru Sasako, Takuji Okusaka, Hirofumi Mukai, Keiichi Fujiwara, Mashio Nakamura, Tetsuya Kimura, Kei Ibusuki, Masato Sakon
INTRODUCTION: Patients with cancer are at higher risk of venous thromboembolism (VTE) than the general population as the malignancy itself and treatment modalities, including medication and surgery, contribute to the risk of developing VTE. Furthermore, patients with cancer developing VTE have a worse prognosis than those without cancer. There are no multicentre prospective data on the occurrence and treatment of VTE in patients with cancer in Japan, and data on the outcomes, complications and incidence of VTE in these patients have not been reported...
May 30, 2018: BMJ Open
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