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Borderline resectable pancreatic cancer

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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
#1
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
#2
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...
December 2016: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/27896469/ct-evaluation-after-neoadjuvant-folfirinox-chemotherapy-for-borderline-and-locally-advanced-pancreatic-adenocarcinoma
#3
Mathilde Wagner, Celia Antunes, Daniel Pietrasz, Christophe Cassinotto, Magaly Zappa, Antonio Sa Cunha, Oliver Lucidarme, Jean-Baptiste Bachet
AIM: To assess anatomic changes on computed tomography (CT) after neoadjuvant FOLFIRINOX (5-fluorouracil/leucovorin/irinotecan/oxaliplatin) chemotherapy for secondary resected borderline resectable (BR) and locally advanced (LA) pancreatic adenocarcinoma and their accuracy to predict resectability and pathological response. METHODS: Thirty-six patients with secondary resected BR/LA pancreatic adenocarcinoma after neoadjuvant FOLFIRINOX chemotherapy (± chemoradiotherapy) were retrospectively included...
November 28, 2016: European Radiology
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
#4
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
#5
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/27865282/techniques-of-vascular-resection-and-reconstruction-in-pancreatic-cancer
#6
REVIEW
George Younan, Susan Tsai, Douglas B Evans, Kathleen K Christians
Multimodality therapy has become the standard approach for the treatment of pancreatic cancer. With improved response rates to newer chemotherapeutic agents, tumors that used to be considered unresectable are now being considered for operation. Neoadjuvant therapy for borderline resectable pancreatic cancer is considered standard of care and venous resection/reconstruction is no longer controversial. Arterial resection and reconstruction in select patients has also proven to be safe when done in highly specialized centers by high-volume surgeons...
December 2016: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27865281/definition-and-management-of-borderline-resectable-pancreatic-cancer
#7
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/27858562/multimodality-therapy-in-patients-with-borderline-resectable-or-locally-advanced-pancreatic-cancer-importance-of-locoregional-therapies-for-a-systemic-disease
#8
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/27858559/cutting-through-confusion-multimodality-therapy-in-borderline-resectable-and-locally-advanced-pancreatic-cancer
#9
Gyulnara G Kasumova, Rebecca A Miksad, Jennifer F Tseng
No abstract text is available yet for this article.
October 2016: Journal of Oncology Practice
https://www.readbyqxmd.com/read/27813710/usefulness-of-three-dimensional-modeling-in-surgical-planning-resident-training-and-patient-education
#10
Ciro Andolfi, Alejandro Plana, Patrick Kania, P Pat Banerjee, Stephen Small
BACKGROUND: Imaging has a critical impact on surgical decision making and three-dimensional (3D) digital models of patient pathology can now be made commercially. We developed a 3D digital model of a cancer of the head of the pancreas by integrating actual CT data with 3D modeling process. After this process, the virtual pancreatic model was also produced using a high-quality 3D printer. PATIENTS AND METHODS: A 56-year-old female with pancreatic head adenocarcinoma presented with biliary obstruction and jaundice...
November 4, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27760934/-neoadjuvant-chemotherapy-using-s-1-for-pancreatic-cancer-mid-term-results
#11
Yuki Homma, Goro Honda, Katsunori Sakamoto, Masanao Kurata, Masahiko Honjo, Yoshihiro Hirata, Satoshi Shinya
BACKGROUND: Although surgical resection is the only curative strategy for pancreatic cancer, the prognosis of patients with pancreatic cancer remains poor. Recently, neoadjuvant treatment has been frequently employed as a promising treatment. Here, the mid-term results of neoadjuvant chemoradiotherapy(NACRT)using S-1, which has been performed in our hospital since 2008, are reported. METHODS: Seventy-nine patients with resectable or borderline resectable pancreatic ductal adenocarcinoma, who had been intended to undergo NACRT treatment using S-1, were enrolled...
October 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/27760280/venous-thromboembolism-prophylaxis-during-neoadjuvant-therapy-for-resectable-and-borderline-resectable-pancreatic-cancer-is-it-indicated
#12
Ashley N Krepline, Kathleen K Christians, Ben George, Paul S Ritch, Beth A Erickson, Parag Tolat, Douglas B Evans, Susan Tsai
PURPOSE: To describe venous thromboembolism (VTE) rates in patients with pancreatic cancer (PC) during neoadjuvant therapy. METHODS: Factors associated with VTE were evaluated using multivariable logistic regression modeling in patients with resectable and BLR PC treated with neoadjuvant therapy between 2009 and 2014. RESULTS: Prevalent VTEs were detected in 13 (5%) of the 260 patients. Incident VTEs were detected in 26 patients (10%); 9 (8%) of the 109 resectable and 17 (11%) of the 151 BLR patients (P = 0...
October 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27724927/complete-pathological-response-following-neoadjuvant-folfirinox-in-borderline-resectable-pancreatic-cancer-a-case-report-and-review
#13
Mišo Gostimir, Sean Bennett, Terence Moyana, Harman Sekhon, Guillaume Martel
BACKGROUND: Pancreatic cancer is among the top 5 most common cancers worldwide, but is particularly devastating due to its insidious nature. Complete surgical resection remains the only potential curative treatment, although only 20 % of patients present with a resectable tumor. Patients may alternatively present with borderline resectable pancreatic cancer or locally advanced pancreatic cancer and can be offered treatment with neoadjuvant intent. The effectiveness of these treatments is unclear and there is a paucity of data to suggest one optimal treatment approach...
October 10, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27686238/outcomes-after-extended-pancreatectomy-in-patients-with-borderline-resectable-and-locally-advanced-pancreatic-cancer
#14
W Hartwig, A Gluth, U Hinz, D Koliogiannis, O Strobel, T Hackert, J Werner, M W Büchler
BACKGROUND: In the recent International Study Group of Pancreatic Surgery (ISGPS) consensus on extended pancreatectomy, several issues on perioperative outcome and long-term survival remained unclear. Robust data on outcomes are sparse. The present study aimed to assess the outcome of extended pancreatectomy for borderline resectable and locally advanced pancreatic cancer. METHODS: A consecutive series of patients with primary pancreatic adenocarcinoma undergoing extended pancreatectomies, as defined by the new ISGPS consensus, were compared with patients who had a standard pancreatectomy...
September 30, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27676017/volumetric-assessment-of-tumor-vessel-interaction-is-a-predictor-of-surgical-candidacy-in-patients-with-borderline-resectable-and-locally-advanced-pancreatic-cancer-treated-with-stereotactic-body-radiation-therapy
#15
Z Cheng, L M Rosati, L Chen, O Y Mian, A Narang, Y Cao, J Moore, S P Robertson, A Hacker-Prietz, J M Herman, T R McNutt
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27675789/interim-acute-toxicity-analysis-and-surgical-outcomes-of-neoadjuvant-gemcitabine-nab-paclitaxel-and-hypofractionated-image-guided-intensity-modulated-radiation-therapy-in-resectable-and-borderline-resectable-pancreatic-cancer-anchor-study
#16
M Palta, B Czito, J Abbruzzese, H Uronis, E A Duffy, D T Blazer, C G Willett
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27674077/neoadjuvant-stereotactic-body-radiation-therapy-for-borderline-resectable-and-locally-advanced-pancreatic-cancer-prognostic-factors-for-local-recurrence-and-survival
#17
Z D Guss, L M Rosati, C C Hsu, A Hacker-Prietz, J He, T M Pawlik, M A Makary, K Hirose, A De Jesus-Acosta, D T Le, L Zheng, D A Laheru, J L Cameron, C L Wolfgang, M J Weiss, J M Herman
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27674038/neoadjuvant-therapy-for-borderline-resectable-and-locally-advanced-pancreatic-cancer
#18
K Kovtun, J A Moser, M Callery, T Kent, J Tseng, R Miksad, A Bullock, B Schlechter, A Mahadevan
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27674030/does-metabolic-tumor-volume-predict-tumor-regression-grade-after-neoadjuvant-therapy-for-borderline-resectable-pancreatic-cancer
#19
W Jin, E A Mellon, S E Hoffe, J M Frakes, G M Springett, B A Centeno, R Kim, A Mahipal, J M Pimiento, M P Malafa, K Latifi
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27673989/neoadjuvant-radiochemotherapy-for-borderline-and-locally-advanced-pancreatic-cancer-is-a-promising-strategy-to-improve-surgical-resection-rates-and-outcome
#20
V Vendrely, C Pouypoudat, E Buscail, S Cossin, C Cassinotto, E Terrebonne, J F Blanc, C Dupin, C Laurent, S Dabernat, L Chiche
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
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