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Borderline resectable pancreatic cancer

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https://www.readbyqxmd.com/read/28719890/effect-of-neoadjuvant-nab-paclitaxel-plus-gemcitabine-therapy-on-overall-survival-in-patients-with-borderline-resectable-pancreatic-cancer-a-prospective-multicenter-phase-ii-trial-nac-ga-trial
#1
Ken-Ichi Okada, Toshio Shimokawa, Seiko Hirono, Manabu Kawai, Masayuki Sho, Sohei Satoi, Ippei Matsumoto, Hidetoshi Eguchi, Yoshiaki Murakami, Suguru Yamada, Mariko Doi, Hiroki Yamaue
We conducted a prospective multicenter phase II trial of patients with borderline resectable pancreatic carcinoma to investigate the efficacy of neoadjuvant nab-paclitaxel plus gemcitabine therapy on overall survival (OS). The clinical trial primarily evaluated OS time from the first day of protocol therapy as a primary endpoint. The secondary endpoints were recurrence-free survival from the first day of protocol therapy, safety of the protocol therapy (adverse effect), morbidity based on the Clavien Dindo classification of more than III, response rate, preoperative/postoperative tumor marker (CA 19-9, CEA), rate of normalization, reduction rate of the maximum standardized uptake value on positron emission tomography-computed tomography (limited to institutions where positron emission tomography-computed tomography was available), chemotherapeutic effect grade based on Evans' classification, resection rate, R0 resection rate, surgical data (operative time, blood loss, transfusion, postoperative hospital day), overall morbidity rates (reoperation, rate of readmission, mortality), patient rate in postoperative adjuvant therapy (entry rate, completion rate), dose intensity, quality of life regarding fatigue and malaise assessed by the questionnaire of FACIT-F (Japanese version), and peripheral sensory neuropathy assessed by the questionnaire of the FACT/GOG-NTX subscale (version 4; Japanese version)...
July 19, 2017: Oncology
https://www.readbyqxmd.com/read/28708232/primary-signet-ring-cell-carcinoma-of-the-pancreas-with-a-good-response-to-chemotherapy-case-report-and-literature-review
#2
Milan Radojkovic, Dragana Ilic, Ivan Ilic
PURPOSE: Although pancreatic cancer is a common malignancy, signet ring cell carcinoma of the pancreas is a very rare histologic type with only 6 cases reported so far. We present a patient with primary signet ring cell carcinoma of the pancreas and a good response to neoadjuvant chemotherapy. CASE REPORT: A 67-year-old woman presented at a regional hospital with a 2-week history of painless progressive jaundice. Abdominal computed tomography showed a tumor in the head of the pancreas, 4...
July 5, 2017: Tumori
https://www.readbyqxmd.com/read/28705005/radiation-therapy-in-the-management-of-pancreatic-adenocarcinoma-review-of-current-evidence-and-future-opportunities
#3
Tyler P Robin, Karyn A Goodman
The role of radiation therapy for pancreatic cancer is rapidly evolving in every stage of this disease. In resectable disease, there is conflicting evidence for adjuvant therapy, but an ongoing randomized cooperative group trial is attempting to define the role of adjuvant chemoradiation with modern systemic therapies and radiation techniques with an emphasis on radiation quality assurance. In borderline resectable pancreatic cancer (BRPC), there is an emerging body of literature demonstrating the success of neoadjuvant stereotactic body radiation therapy (SBRT) and a randomized cooperative group trial is actively accruing...
June 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28705004/multimodality-management-of-borderline-resectable-pancreatic-adenocarcinoma
#4
Laura R Prakash, Matthew H G Katz
Patients with borderline resectable pancreatic adenocarcinoma have primary tumors within the pancreas that involve the mesenteric vasculature to a limited degree. Their tumors are nonetheless at high-risk for a microscopically positive surgical resection margin and/or early treatment failure when pancreatectomy is performed de novo. The optimal treatment strategy for these patients has not been established; however, relatively favorable outcomes can be achieved with systemic chemotherapy and radiation therapy (RT) prior to intended resection...
June 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28700786/neoadjuvant-treatment-in-locally-advanced-and-borderline-resectable-pancreatic-cancer-vs-primary-resectable-pancreatic-cancer
#5
Marco Del Chiaro, Roberto Valente, Urban Arnelo
No abstract text is available yet for this article.
July 12, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28685356/is-pancreatic-head-cancer-with-portal-venous-involvement-really-borderline-resectable-appraisal-of-an-upfront-surgery-series
#6
Katsuhisa Ohgi, Yusuke Yamamoto, Teiichi Sugiura, Yukiyasu Okamura, Takaaki Ito, Ryo Ashida, Takeshi Aramaki, Katsuhiko Uesaka
BACKGROUND: It remains controversial whether the degree of venous involvement really is associated with borderline resectability of pancreatic cancer. METHODS: A single-center retrospective review of patients who underwent upfront pancreaticoduodenectomy for T3 pancreatic cancer without arterial involvement was performed. The patients were classified as having resectable tumors without venous contact (R group), resectable tumors with venous contact of 180° or less (R-PV group), and borderline resectable tumors with venous contact greater than 180° (BR-PV group)...
July 6, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28682880/portal-vein-superior-mesenteric-vein-resection-in-pancreatic-cancer-treatment-in-the-elderly
#7
Jiong-Ze Fang, Cai-De Lu, Sheng-Dong Wu, Jing Huang, Jie Zhou
There is an increased interest in extending surgical criteria for pancreatic cancer by performing pancreaticoduodenectomy (PD) combined with portal vein (PV) or superior mesenteric vein (SMV) resection and reconstruction for borderline resectable patients. However, whether this procedure suitable for elderly patients remains unclear. Here, we studied cases of pancreatic cancer treatment in our medical center to evaluate feasibility and safety of this procedure in the elderly.Eighty-three patients 65 years of age or older who underwent PD from January 2009 to March 2014 were divided into 2 groups: PD only (Group A, 52 cases), and PD combined with PV/SMV resection and reconstruction (Group B, 31 cases)...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28658869/role-of-multi-detector-computed-tomography-mdct-in-preoperative-staging-of-pancreatic-carcinoma
#8
Soumil Singhal, Nirmal Kumar Prabhu, Pulkit Sethi, Srikanth Moorthy
INTRODUCTION: Pancreatic carcinoma is one of the leading causes of cancer related death in advanced countries and has shown rising trends in developing countries like India. Increase in the incidence has been linked to risk factors like lifestyle modification associated with increased alcohol consumption and rapid urbanization. Most patients at the time of diagnosis present with an advanced condition. Surgical resection offers the only chance for cure in them and imaging plays a crucial role in the early diagnosis of the condition...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28655416/evaluation-and-proposal-of-novel-resectability-criteria-for-pancreatic-cancer-established-by-the-japan-pancreas-society
#9
Suguru Yamada, Tsutomu Fujii, Hideki Takami, Masamichi Hayashi, Naoki Iwata, Mitsuro Kanda, Chie Tanaka, Hiroyuki Sugimoto, Goro Nakayama, Masahiko Koike, Michitaka Fujiwara, Yasuhiro Kodera
BACKGROUND: The guidelines for the classification of the resectability of pancreatic cancer established by the National Comprehensive Cancer Network can be difficult to utilize in clinical practice. We evaluated novel criteria proposed by the Japan Pancreas Society. METHODS: We analyzed 382 patients with pancreatic cancer between 2001 and 2015 for survival differences among subgroups classified according to the Japan Pancreas Society classification. Overall survival and disease-free survival were expressed as median values and compared with data based on the National Comprehensive Cancer Network classification, and differences in initial patterns of recurrence were analyzed...
June 24, 2017: Surgery
https://www.readbyqxmd.com/read/28639410/long-term-survival-benefit-of-upfront-chemotherapy-in-patients-with-newly-diagnosed-borderline-resectable-pancreatic-cancer
#10
Bikram Shrestha, Yifei Sun, Farzana Faisal, Victoria Kim, Kevin Soares, Alex Blair, Joseph M Herman, Amol Narang, Avani S Dholakia, Lauren Rosati, Amy Hacker-Prietz, Linda Chen, Daniel A Laheru, Ana De Jesus-Acosta, Dung T Le, Ross Donehower, Nilofar Azad, Luis A Diaz, Adrian Murphy, Valerie Lee, Elliot K Fishman, Ralph H Hruban, Tingbo Liang, John L Cameron, Martin Makary, Matthew J Weiss, Nita Ahuja, Jin He, Christopher L Wolfgang, Chiung-Yu Huang, Lei Zheng
The use of neoadjuvant chemotherapy or radiation for borderline resectable pancreatic adenocarcinoma (BL-PDAC) is increasing. However, the impact of neoadjuvant chemotherapy and radiation therapy on the outcome of BL-PDAC remains to be elucidated. We performed a retrospective analysis of 93 consecutive patients who were diagnosed with BL-PDAC and primarily followed at Johns Hopkins Hospital between February 2007 and December 2012. Among 93 patients, 62% received upfront neoadjuvant chemotherapy followed by chemoradiation, whereas 20% received neoadjuvant chemoradiation alone and 15% neoadjuvant chemotherapy alone...
July 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28638216/role-of-surgery-in-pancreatic-cancer
#11
EDITORIAL
Trond A Buanes
Treatment of pancreatic cancer is multimodal and surgery is an essential part, mandatory for curative potential. Also chemotherapy is essential, and serious postoperative complications or rapid disease progression may preclude completion of multimodal treatment. The sequence of treatment interventions has therefore become an important concern, and numerous ongoing randomized controlled trials compare clinical outcome after upfront surgery and neoadjuvant treatment with subsequent resection. In previous years, borderline resectable and locally advanced pancreatic cancer was most often considered unresectable...
June 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28620900/new-treatment-options-and-management-considerations-in-borderline-resectable-pancreatic-cancer
#12
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/28608409/neoadjuvant-chemoradiotherapy-of-pancreatic-cancer-induces-a-favorable-immunogenic-tumor-microenvironment-associated-with-increased-major-histocompatibility-complex-class-i-related-chain-a-b-expression
#13
Takashi Murakami, Yuki Homma, Ryusei Matsuyama, Ryutaro Mori, Kentaro Miyake, Yusaku Tanaka, Kanechika Den, Yoji Nagashima, Masatoshi Nakazawa, Yukihiko Hiroshima, Michio Ueda, Kuniya Tanaka, Robert M Hoffman, Michael Bouvet, Itaru Endo
BACKGROUND: Damage-associated molecular patterns (DAMPs) are related to immune responses in malignant tumors including tumor-infiltrating lymphocytes (TILs). The aim of the present study was to determine the relationship between expression of components of DAMPs and TILs in pancreatic cancer patients who underwent neoadjuvant chemoradiotherapy (NACRT) versus those who did not. METHODS: NACRT was administered to 51 patients with borderline-resectable pancreatic cancer and not to 33 patients with resectable pancreatic cancer...
June 12, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28608305/quality-assurance-of-the-preopanc-trial-2012-003181-40-for-preoperative-radiochemotherapy-in-pancreatic-cancer-the-dummy-run
#14
Eva Versteijne, Eelco Lens, Astrid van der Horst, Arjan Bel, Jorrit Visser, Cornelis J A Punt, Mustafa Suker, Casper H J van Eijck, Geertjan van Tienhoven
BACKGROUND: The Dutch Pancreatic Cancer Group initiated the national, multicentre, controlled PREOPANC trial, randomising between preoperative radiochemotherapy and direct explorative laparotomy for patients with (borderline) resectable pancreatic cancer. The aim of this dummy run is to evaluate compliance with the radiotherapy protocol of this trial, and the quality of delineation and radiation plans. METHODS: Eleven radiation oncology departments open for accrual of patients in the PREOPANC trial were provided with all necessary information of a selected 'dummy' patient...
June 12, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28608121/a-prospective-phase-ii-trial-of-neoadjuvant-s-1-with-concurrent-hypofractionated-radiotherapy-in-patients-with-resectable-and-borderline-resectable-pancreatic-ductal-adenocarcinoma
#15
Keiichi Okano, Hironobu Suto, Minoru Oshima, Eri Maeda, Naoki Yamamoto, Keitaro Kakinoki, Hideki Kamada, Tsutomu Masaki, Shigeo Takahashi, Toru Shibata, Yasuyuki Suzuki
BACKGROUND: The ideal neoadjuvant treatment protocol for patients with pancreatic cancer (PDAC) remains unclear. We evaluated the efficacy and safety of neoadjuvant hypofractionated chemoradiotherapy with S-1 for patients with resectable (R) and borderline resectable (BR) PDAC. METHODS: Eligibility criteria included patients with R and BR PDAC, performance status 0-1, and age 20-85 years. Hypofractionated external-beam radiotherapy (30 Gy in 10 fractions) with concurrent S-1 (60 mg/m(2)) was delivered 5 days/week for 2 weeks prior to pancreatectomy...
June 12, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28599404/neoadjuvant-chemotherapy-for-pancreatic-cancer-effects-on-cancer-tissue-and-novel-perspectives
#16
Hidehiro Tajima, Isamu Makino, Yoshinao Ohbatake, Shinichi Nakanuma, Hironori Hayashi, Hisatoshi Nakagawara, Tomoharu Miyashita, Hiroyuki Takamura, Tetsuo Ohta
Chemotherapy for pancreatic cancer has diversified following the addition of more treatment regimens; however, in spite of this, pancreatic cancer remains a fatal disease. Preoperative (neoadjuvant) chemotherapy (NAC) or neoadjuvant chemoradiation therapy (NACRT) has been developed and implemented. For patients with borderline resectable pancreatic cancer (BRPC) and locally advanced pancreatic cancer (LAPC), a number of clinical trials have been conducted; NACRT was demonstrated to improve resectability, R0 resection rate, overall survival rate, disease-free survival rate and even an LAPC and BRPC survival advantage over NAC...
June 2017: Oncology Letters
https://www.readbyqxmd.com/read/28597320/diagnostic-laparoscopy-prior-to-neoadjuvant-therapy-in-pancreatic-cancer-is-high-yield-an-analysis-of-outcomes-and-costs
#17
June S Peng, Jeffrey Mino, Rosebel Monteiro, Gareth Morris-Stiff, Noaman S Ali, Jane Wey, Kevin M El-Hayek, R Matthew Walsh, Sricharan Chalikonda
BACKGROUND: There is currently no standardized regimen for management of borderline resectable pancreatic cancer (BRPC), and treatment includes varying sequences of surgery, chemotherapy, and/or radiation. This study examines the diagnostic yield and cost of performing staging diagnostic laparoscopy (SDL) prior to neoadjuvant therapy (NAT) in BRPC. METHODS: Sequential patients treated for BRPC between January 2010 and October 2013 were included. SDL was adopted in a staged fashion due to surgeon preference, and included biopsy of visible lesions and washings for cytology...
June 8, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28588713/neoadjuvant-chemotherapy-in-borderline-resectable-pancreatic-cancer-a-case-report
#18
Maria Celeste Palmarocchi, Ruben Carlo Balzarotti Canger, Piercarlo Saletti
Pancreatic cancer is the fourth leading cause of cancer mortality and is associated with a poor overall survival even when diagnosed early and considered resectable. Complete surgical removal with negative histological margins is an independent predictor of survival and remains the only potential curative treatment. In borderline resectable pancreatic adenocarcinoma (BRPAC), preoperative systemic therapy may increase resectability and margin-negative resection rate. There is no current consensus on the optimal chemotherapy regimen for BRPAC...
June 2017: Oncology Letters
https://www.readbyqxmd.com/read/28564637/efficacy-and-safety-of-neoadjuvant-folfirinox-for-borderline-resectable-pancreatic-adenocarcinoma-improved-efficacy-compared-with-gemcitabine-based-regimen
#19
Changhoon Yoo, Jihoon Kang, Kyu-Pyo Kim, Jae-Lyun Lee, Baek-Yeol Ryoo, Heung-Moon Chang, Sang Soo Lee, Do Hyun Park, Tae Jun Song, Dong Wan Seo, Sung Koo Lee, Myung-Hwan Kim, Jin-Hong Park, Dae Wook Hwang, Ki Byung Song, Jae Hoon Lee, Song Cheol Kim
Borderline resectable pancreatic cancer (BRPC) is a potentially resectable disease but is associated with poorer survival compared to primary resectable disease. There has been no prospective trial that compare the efficacy of FOLFIRNOX and gemcitabine-based regimen for BRPC. Between February 2013 and December 2014, 18 patients with BRPC receiving FOLFIRINOX were reviewed retrospectively. For comparative analysis, data for all BRPC patients (n=18) in our previous phase 2 study of neoadjuvant fixed-dose rate-gemcitabine plus capecitabine were pooled...
July 11, 2017: Oncotarget
https://www.readbyqxmd.com/read/28561672/pancreatic-adenocarcinoma-improving-prevention-and-survivorship
#20
Davendra P S Sohal, Field F Willingham, Massimo Falconi, Kara L Raphael, Stefano Crippa
Pancreatic cancer is a growing problem in oncology, given slowly rising incidence and continued suboptimal outcomes. A concerted effort to reverse this tide will require prevention, early diagnosis, and improved systemic therapy for curable disease. We focus on these aspects in detail in this study. Hereditary pancreatic cancer is an underappreciated area. With the growing use of genomics (both somatic and germline) in cancer care, there is increasing recognition of hereditary pancreatic cancer cases: around 10% of all pancreatic cancer may be related to familial syndromes, such as familial atypical multiple mole and melanoma (FAMMM) syndrome, hereditary breast and ovarian cancer, Lynch syndrome, and Peutz-Jeghers syndrome...
2017: American Society of Clinical Oncology Educational Book
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