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Borderline resectable pancreatic cancer

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https://www.readbyqxmd.com/read/28923230/randomized-clinical-trials-in-pancreatic-cancer
#1
REVIEW
Neha Goel, Sanjay S Reddy
The management of pancreatic cancer has grown rapidly in the last decade. The Gastrointestinal Tumor Study Group trial in 1985 supported postoperative chemoradiation, and a more recent study recommended 6 months of adjuvant gemcitabine and capecitabine or monotherapy with gemcitabine or fluorouracil plus folinic acid, in the absence of neoadjuvant therapy. Clinicians are now studying the role of targeted therapy in pancreatic cancer and neoadjuvant chemotherapy in resectable, borderline resectable, and locally advanced pancreatic cancer...
October 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28911082/borderline-resectable-pancreatic-cancer-an-evolving-concept
#2
N Petrucciani, T Debs, G Nigri, F D'Angelo, J Gugenheim, G Ramacciato
No abstract text is available yet for this article.
September 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28886941/should-functional-renal-scans-be-obtained-prior-to-upper-abdominal-imrt-for-pancreatic-cancer
#3
Grace C Blitzer, William A Hall, Susan Tsai, Mohammed Aldakkak, Robert S Hellman, Douglas B Evans, Kathleen K Christians, Ben George, Paul S Ritch, Beth A Erickson
BACKGROUND: Upper abdominal irradiation for pancreatic cancer is administered in close proximity to the radiation-sensitive kidneys. There is difficulty in defining dose-volume parameters to predict late renal toxicity after partial kidney irradiation. Less than 10% of the general population is estimated to have asymmetrical kidney function; however, there are no studies that examine this in patients with pancreatic cancer. The primary purpose of this study was to determine the prevalence of asymmetrical kidney function in patients with pancreatic cancer...
June 29, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28835777/current-status-on-the-place-of-folfirinox-in-metastatic-pancreatic-cancer-and-future-directions
#4
REVIEW
Aurélien Lambert, Céline Gavoille, Thierry Conroy
Pancreatic cancer (PC) incidence rates are rapidly increasing in developed countries, with half the patients being metastatic at diagnosis. For decades, fluorouracil, then gemcitabine regimens were the preferred palliative first-line options for fit patients with metastatic PC. FOLFIRINOX (a combination of bolus and infusional fluorouracil, leucovorin, irinotecan and oxaliplatin) was introduced to clinical practice in 2010 due to the results of the phase II/III trial (PRODIGE 4/ACCORD 11) comparing FOLFIRINOX with single-agent gemcitabine as first-line treatment for patients with MPC...
August 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28833055/impact-of-portal-vein-infiltration-and-type-of-venous-reconstruction-in-surgery-for-borderline-resectable-pancreatic-cancer
#5
MULTICENTER STUDY
R Ravikumar, C Sabin, M Abu Hilal, A Al-Hilli, S Aroori, G Bond-Smith, S Bramhall, C Coldham, J Hammond, R Hutchins, C Imber, G Preziosi, A Saleh, M Silva, J Simpson, G Spoletini, D Stell, J Terrace, S White, S Wigmore, G Fusai
BACKGROUND: The International Study Group of Pancreatic Surgery (ISGPS) recommends operative exploration and resection of pancreatic cancers in the presence of reconstructable mesentericoportal axis involvement. However, there is no consensus on the ideal method of vascular reconstruction. The effect of depth of tumour invasion of the vessel wall on outcome is also unknown. METHODS: This was a retrospective cohort study of pancreaticoduodenectomy with vein resection for T3 adenocarcinoma of the head of the pancreas across nine centres...
October 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28750659/alliance-for-clinical-trials-in-oncology-alliance-trial-a021501-preoperative-extended-chemotherapy-vs-chemotherapy-plus-hypofractionated-radiation-therapy-for-borderline-resectable-adenocarcinoma-of-the-head-of-the-pancreas
#6
Matthew H G Katz, Fang-Shu Ou, Joseph M Herman, Syed A Ahmad, Brian Wolpin, Robert Marsh, Spencer Behr, Qian Shi, Michael Chuong, Lawrence H Schwartz, Wendy Frankel, Eric Collisson, Eugene J Koay, JoLeen M Hubbard, James L Leenstra, Jeffrey Meyerhardt, Eileen O'Reilly
BACKGROUND: Borderline resectable pancreatic cancers infiltrate into adjacent vascular structures to an extent that makes an R0 resection unlikely when pancreatectomy is performed de novo. In a pilot study, Alliance for Clinical Trials in Oncology Trial A021101, the median survival of patients who received chemotherapy and radiation prior to anticipated pancreatectomy was 22 months, and 64% of operations achieved an R0 resection. However, the individual contributions of preoperative chemotherapy and radiation therapy to therapeutic outcome remain poorly defined...
July 27, 2017: BMC Cancer
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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...
September 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
#20
MULTICENTER STUDY
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...
August 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
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