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JOURNAL ARTICLE
Shota Harai, Susumu Hijioka, Reiko Yamada, Takeshi Ogura, Mitsuharu Fukasawa, Atsushi Okuda, Hideyuki Horike, Dai Inoue, Masanari Sekine, Yusuke Ishida, Takehiko Koga, Hidetoshi Kitamura, Yasuhito Tanaka, Motohiro Yoshinari, Katsumasa Kobayashi, Mark Chatto, Daiki Yamashige, Yuki Kawasaki, Yoshikuni Nagashio, Takuji Okusaka
BACKGROUND AND AIM: The 10-mm self-expandable metal stent (SEMS) is the standard for endoscopic transpapillary biliary drainage before pancreatic cancer surgery. However, the efficacy of stents thinner than 10 mm has not been adequately validated. Therefore, we aimed to evaluate the safety of a 6-mm fully covered SEMS (FCSEMS) for distal malignant biliary obstruction (DMBO) during preoperative chemotherapy for pancreatic cancer. METHODS: This was a single-arm, multicenter, prospective phase II study of endoscopic transpapillary initial biliary drainage for DMBO before pancreatic cancer surgery...
February 29, 2024: Journal of Gastroenterology and Hepatology
#22
REVIEW
J Boustani, F Huguet, V Vendrely
Gastrointestinal cancers are one of the most frequent cancers and a leading cause of cancer deaths worldwide. We provide an overview of the most important practice-changing trials that were either published or presented at the international scientific meetings in 2021-2023. Highlights included reports on three phase III trials (CONCORDE/PRODIGE 26, ARTDECO, and a study by Xu et al.) that evaluated dose escalation in the definitive setting for locally advanced oesophageal cancers, as well as two phase III trials that evaluated the role of chemotherapy (neo-AEGIS) and targeted therapy (NRG/RTOG 1010) in the neoadjuvant setting for adenocarcinoma oesophageal cancers or gastroesophageal junction cancer...
December 2023: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
#23
JOURNAL ARTICLE
Ugo Boggi, Emanuele Kauffmann, Niccolò Napoli, S George Barreto, Marc G Besselink, Giuseppe K Fusai, Thilo Hackert, Mohammad Abu Hilal, Giovanni Marchegiani, Roberto Salvia, Shailesh Shrikhande, Mark Truty, Jens Werner, Christopher Wolfgang, Elisa Bannone, Giovanni Capretti, Alice Cattelani, Alessandro Coppola, Alessandro Cucchetti, Davide De Sio, Armando Di Dato, Giovanna Di Meo, Claudio Fiorillo, Cesare Gianfaldoni, Michael Ginesini, Camila Hidalgo Salinas, Quirino Lai, Mario Miccoli, Roberto Montorsi, Michele Pagnanelli, Andrea Poli, Claudio Ricci, Francesco Sucameli, Domenico Tamburrino, Virginia Viti, Pietro F Addeo, Sergio Alfieri, Philippe Bachellier, Gianluca Baiocchi, Gianpaolo Balzano, Linda Barbarello, Alberto Brolese, Juli Busquets, Giovanni Butturini, Fabio Caniglia, Damiano Caputo, Riccardo Casadei, Xi Chunhua, Ettore Colangelo, Andrea Coratti, Francesca Costa, Francesco Crafa, Raffaele Dalla Valle, Luciano De Carlis, Roeland F de Wilde, Marco Del Chiaro, Fabrizio Di Benedetto, Pierluigi Di Sebastiano, Safi Domak, Melissa Hogg, Vyacheslav I Egorov, Giorgio Ercolani, Giuseppe Maria Ettorre, Massimo Falconi, Giovanni Ferrari, Alessandro Ferrero, Marco Filauro, Alessandro Giardino, Gian Luca Grazi, Salvatore Gruttaduaria, Jakob R Izbicki, Elio Jovine, Matthew Katz, Tobias Keck, Igor Khatkov, Gozo Kiguchi, David Kooby, Hauke Lang, Carlo Lombardo, Giuseppe Malleo, Marco Massani, Vincenzo Mazzaferro, Riccardo Memeo, Yi Miao, Kohei Mishima, Carlo Molino, Yuichi Nagakawa, Masafumi Nakamura, Bruno Nardo, Fabrizio Panaro, Claudio Pasquali, Vittorio Perrone, Elena Rangelova, Long Riu, Renato Romagnoli, Raffaele Romito, Edoardo Rosso, Richard Schulick, Ajith Siriwardena, Marcello Spampinato, Oliver Strobel, Mario Testini, Roberto Troisi, Faik G Uzunoglo, Roberto Valente, Luigi Veneroni, Alessandro Zerbi, Emilio Vicente, Fabio Vistoli, Marco Vivarelli, Go Wakabayashi, Giacomo Zanus, Amer Zureikat, Nicholas J Zyromski, Roberto Coppola, Vito D'Andrea, José Davide, Christos Dervenis, Isabella Frigerio, Kevin C Konlon, Fabrizio Michelassi, Marco Montorsi, William Nealon, Nazario Portolani, Donzília Sousa Silva, Giuseppe Bozzi, Viviana Ferrari, Maria G Trivella, John Cameron, Pierre-Alain Clavien, Horacio J Asbun
OBJECTIVE: The REDISCOVER consensus conference aimed at developing and validate guidelines on the perioperative care of patients with borderline resectable (BR-) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC). SUMMARY BACKGROUND DATA: Coupled with improvements in chemotherapy and radiation, the contemporary approach to pancreatic surgery supports resection of BR-PDAC and, to a lesser extent, LA-PDAC. Guidelines outlining the selection and perioperative care for these patients are lacking...
February 26, 2024: Annals of Surgery
#24
JOURNAL ARTICLE
Ross J Taylor, Gregory J Matthews, Robert H Aseltine, Emma C Fields
PURPOSE: Surgical resection remains the only curative therapy for pancreatic cancer. Unfortunately, many patients have borderline or unresectable disease at diagnosis due to proximity of major abdominal vessels. Neoadjuvant chemotherapy and radiation are used to down-stage, however, there is a risk that there will be a positive/close surgical margin. The CivaSheet is a low-dose-rate (LDR) brachytherapy device placed at the time of surgery to target the area of highest risk of margin positivity...
February 23, 2024: Brachytherapy
#25
JOURNAL ARTICLE
Maciej Borys, Michał Wysocki, Krystyna Gałązka, Maciej Stanek, Andrzej Budzyński
PURPOSE: The aim of this study was to establish whether laparoscopic RAMPS (L-RAMPS) is a safe procedure with better oncological outcomes compared to laparoscopic distal pancreatectomy (LDP) with splenectomy among patients with distal pancreatic ductal adenocarcinoma (PDAC). METHODS: This is a retrospective study performed on consecutive patients who underwent L-RAMPS and LDP with splenectomy for resectable or borderline resectable PDAC of the body and tail. In this paper, we presented our technique of laparoscopic RAMPS and analyzed intraoperative and perioperative complications, oncological efficacy, and long-term survival...
February 24, 2024: Langenbeck's Archives of Surgery
#26
JOURNAL ARTICLE
Hyunseok Yoon, Yeokyeong Shin, Baek-Yeol Ryoo, Hyehyun Jeong, Inkeun Park, Dong-Wan Seo, Sang Soo Lee, Do Hyun Park, Tae Jun Song, Dongwook Oh, Dae Wook Hwang, Jae Hoon Lee, Ki Byung Song, Yejong Park, Bong Jun Kwak, Seung-Mo Hong, Jin-Hong Park, Song Cheol Kim, Kyu-Pyo Kim, Changhoon Yoo
BACKGROUND: Modified FOLFIRINOX (mFOLFIRINOX) is one of the standard first-line therapies in borderline resectable pancreatic cancer (BRPC) and locally advanced unresectable pancreatic cancer (LAPC). However, there is no globally accepted second-line therapy following progression on mFOLFIRINOX. METHODS: Patients with BRPC and LAPC (n = 647) treated with first-line mFOLFIRINOX between January 2017 and December 2020 were included in this retrospective analysis...
February 19, 2024: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
#27
JOURNAL ARTICLE
Zachary J Brown, Alexander H Shannon, Jordan M Cloyd
Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive tumor with poor prognosis and rising incidence globally. Multimodal therapy that includes surgical resection and chemotherapy with or without radiation offers the best chance for optimal outcomes. The development of established criteria for anatomic staging of local primary tumors into potentially resectable (PR), borderline resectable (BR), and locally advanced (LA) has greatly clarified the optimal treatment strategies. While upfront surgical resection was traditionally the recommended approach for localized PDAC, increasingly neoadjuvant therapy (NT) is recommended prior to surgery...
February 22, 2024: Minerva surgery
#28
JOURNAL ARTICLE
Hye-Sol Jung, Youngmin Han, Won-Gun Yun, Young Jae Cho, Mirang Lee, Dong Ho Lee, Wooil Kwon, Jin-Young Jang
INTRODUCTION: The applicability of neoadjuvant treatment (NAT) for resectable pancreatic ductal adenocarcinoma (PDAC) has arisen, however, high-level evidence is lacking. This study aimed to explore patient subgroups with high-risk resectable PDAC for selecting candidates who may benefit from NAT. METHODS: The 1,132 patients with resectable or borderline resectable PDAC who underwent surgery between 2007 and 2021 were retrospectively reviewed. Patients with resectable PDAC without contact of major vessels (R-no contact) (n=651), with contact of portal vein or superior mesenteric vein (PV/SMV) ≤180° (R-contact) (n=306), and borderline resectable PDAC without arterial involvement (BR-V) (n=175) were analyzed...
February 19, 2024: International Journal of Surgery
#29
JOURNAL ARTICLE
Mohamed A Shouman, Frederik Fuchs, Franziska Walter, Stefanie Corradini, C Benedikt Westphalen, Marlies Vornhülz, Georg Beyer, Dorian Andrade, Claus Belka, Maximilian Niyazi, Paul Rogowski
PURPOSE: This systematic review aims to comprehensively summarize the current prospective evidence regarding Stereotactic Body Radiotherapy (SBRT) in various clinical contexts for pancreatic cancer including its use as neoadjuvant therapy for borderline resectable pancreatic cancer (BRPC), induction therapy for locally advanced pancreatic cancer (LAPC), salvage therapy for isolated local recurrence (ILR), adjuvant therapy after radical resection, and as a palliative treatment. Special attention is given to the application of magnetic resonance-guided radiotherapy (MRgRT)...
March 2024: Clinical and Translational Radiation Oncology
#30
JOURNAL ARTICLE
Satoru Miyahara, Hidenori Takahashi, Hirofumi Akita, Kazuki Sasaki, Yosuke Mukai, Yoshifumi Iwagami, Shinichiro Hasegawa, Daisaku Yamada, Yoshito Tomimaru, Takehiro Noda, Hiroshi Wada, Shogo Kobayashi, Yuichiro Doki, Hidetoshi Eguchi
BACKGROUND: Appropriate re-evaluation after neoadjuvant treatment (NAT) is important for optimal treatment selection. Nonetheless, determining the operative eligibility of patients with a modest radiologic response remains controversial. This study aimed to assess the prognostic significance of biologic factors for patients showing a modest radiologic response to NAT and investigate the tumor markers (TMs), CA19-9 alone, DUPAN-II alone, and their combination, to create an index that combines these sialyl-Lewis antigen-related TMs associated with treatment outcomes...
February 17, 2024: Annals of Surgical Oncology
#31
JOURNAL ARTICLE
Nicole Libbey, Lindsey Gallagher, Jonathan Cantalino, Benjamin A Weinberg, Marcus S Noel, Aiwu R He, Pejman Radkani, John L Marshall, Louis M Weiner, Patrick G Jackson, Thomas M Fishbein, Emily R Winslow, Nadim Haddad, Abdul Rashid, Keith R Unger
BACKGROUND: The role of neoadjuvant stereotactic body radiation therapy (SBRT) in the treatment of pancreatic adenocarcinoma (PDAC) is controversial and the optimal target volumes and dose-fractionation are unclear. The aim of this study is to report on treatment outcomes and patterns of failure of patients with borderline resectable (BL) or locally advanced (LA) pancreatic cancer following preoperative chemotherapy and SBRT. METHODS: We conducted a single-institution, retrospective study of patients with BL or LA PDAC...
February 13, 2024: Journal of Gastrointestinal Cancer
#32
JOURNAL ARTICLE
Jacqueline I Bereska, Boris V Janssen, C Yung Nio, Marnix P M Kop, Geert Kazemier, Olivier R Busch, Femke Struik, Henk A Marquering, Jaap Stoker, Marc G Besselink, Inez M Verpalen
OBJECTIVE: This study aimed to develop and evaluate an automatic model using artificial intelligence (AI) for quantifying vascular involvement and classifying tumor resectability stage in patients with pancreatic ductal adenocarcinoma (PDAC), primarily to support radiologists in referral centers. Resectability of PDAC is determined by the degree of vascular involvement on computed tomography scans (CTs), which is associated with considerable inter-observer variability. METHODS: We developed a semisupervised machine learning segmentation model to segment the PDAC and surrounding vasculature using 613 CTs of 467 patients with pancreatic tumors and 50 control patients...
February 12, 2024: European Radiology Experimental
#33
JOURNAL ARTICLE
Kangpyo Kim, Hee Chul Park, Jeong Il Yu, Joon Oh Park, Jung Yong Hong, Kyu Taek Lee, Kwang Hyuck Lee, Jong Kyun Lee, Joo Kyung Park, Jin Seok Heo, Sang Hyun Shin, Ji Hye Min, Kyunga Kim, In Woong Han
BACKGROUND: To evaluate the efficacy and optimal timing of local treatment in patients with borderline resectable (BR) or locally advanced pancreatic cancer (LAPC) treated with upfront FOLFIRINOX. METHOD: Between 2015 and 2020, 258 patients with pancreatic ductal adenocarcinoma (PDAC) were analysed. Treatment outcomes were compared between systemic treatment group (ST) and multimodality treatment groups (MT) using Kaplan-Meier curves and log-rank test. The MT were stratified as follows: FOLFIRINOX + radiation therapy (RT) (MT1), FOLFIRINOX + surgical resection (MT2), and FOLFIRINOX + RT + surgical resection (MT3)...
March 2024: Clinical and Translational Radiation Oncology
#34
JOURNAL ARTICLE
Esther N Dekker, Jacob L van Dam, Quisette P Janssen, Marc G Besselink, Annissa DeSilva, Deesje Doppenberg, Casper H J van Eijck, Naaz Nasar, Eileen M O'Reilly, Alessandro Paniccia, Laura R Prakash, Ching-Wei D Tzeng, Eva M M Verkolf, Alice C Wei, Amer H Zureikat, Matthew H G Katz, Bas Groot Koerkamp
PURPOSE: Previous studies suggest that besides anatomy (A: resectable, borderline resectable [BR], or locally advanced [LA]) also biologic (B: carbohydrate antigen 19-9 [CA 19-9]) and conditional (C: performance status) factors should be considered when staging patients with localized pancreatic ductal adenocarcinoma (PDAC). The prognostic value of the combined ABC factors has not been quantitatively validated. METHODS: In this retrospective cohort study, we evaluated patients with localized PDAC treated with initial (modified) fluorouracil with leucovorin, irinotecan, and oxaliplatin ([m]FOLFIRINOX) at five high-volume pancreatic cancer centers in the United States and the Netherlands (2012-2019)...
February 5, 2024: Journal of Clinical Oncology
#35
JOURNAL ARTICLE
Evelyn Waugh, Juan Glinka, Daniel Breadner, Rachel Liu, Ephraim Tang, Laura Allen, Stephen Welch, Ken Leslie, Anton Skaro
BACKGROUNDS/AIMS: While patients with borderline resectable pancreatic cancer (BRPC) are a target population for neoadjuvant chemotherapy (NAC), formal guidelines for neoadjuvant therapy are lacking. We assessed the perioperative and oncological outcomes in patients with BRPC undergoing NAC with FOLFIRINOX for patients undergoing upfront surgery (US). METHODS: The AHPBA criteria for borderline resectability and/or a CA19-9 level > 100 μ/mL defined borderline resectable tumors retrieved from a prospectively populated institutional registry from 2007 to 2020...
February 1, 2024: Annals of Hepato-Biliary-Pancreatic Surgery
#36
JOURNAL ARTICLE
Kai Tai Derek Yeung, Joseph Doyle, Sacheen Kumar, Katharine Aitken, Diana Tait, David Cunningham, Long R Jiao, Ricky Harminder Bhogal
INTRODUCTION: Neoadjuvant treatment (NAT) for borderline (BD) or locally advanced (LA) primary pancreatic cancer (PDAC) is now a widely adopted approach. We present a case series of patients who have achieved a complete pathological response of the primary tumour on final histology following neoadjuvant chemotherapy +/- chemoradiation and radical surgery. METHODS: Patients who underwent radical pancreatic resection following neoadjuvant treatment between March 2006 and March 2023 at a single institution were identified by retrospective case note review of a prospectively maintained database...
January 20, 2024: Cancers
#37
REVIEW
Sarah E Hoffe, Todd A Aguilera, Parag J Parikh, Maged M Ghaly, Joseph M Herman, Joseph M Caster, Dae Won Kim, James Costello, Mokenge P Malafa, Elizabeth C Moser, Eugene P Kennedy, Kara Terry, Michael Kurman
Ablative doses of stereotactic body radiotherapy (SBRT) may improve pancreatic cancer outcomes but may carry greater potential for gastrointestinal toxicity. Rucosopasem, an investigational selective dismutase mimetic that converts superoxide to hydrogen peroxide, can potentially increase tumor control of SBRT without compromising safety. GRECO-2 is a phase II, multicenter, randomized, double-blind, placebo-controlled trial of rucosopasem in combination with SBRT in locally advanced or borderline resectable pancreatic cancer...
January 24, 2024: Future Oncology
#38
JOURNAL ARTICLE
Kang Xue, Xing Huang, Pengcheng Zhao, Yi Zhang, Bole Tian
BACKGROUND: Pancreatic cancer frequently involves the surrounding major arteries, preventing surgeons from making a radical excision. Neoadjuvant therapy (NAT) can lessen the size of local tumors and eliminate potential micrommetastases. However, systematic and evidence-based recommendations for the treatment of arterial resection (AR) after NAT in pancreatic cancer are scarce. METHOD: A computerized search of the Medline, Embase, Cochrane Library databases, and Clinicaltrials was performed to identify studies reporting the outcomes of patients who underwent pancreatectomy with AR and NAT for pancreatic cancer...
December 1, 2023: International Journal of Surgery
#39
JOURNAL ARTICLE
Julia Madlaina Kunz, Peter Maloca, Andreas Allemann, David Fasler, Savas Soysal, Silvio Däster, Marko Kraljević, Gulbahar Syeda, Benjamin Weixler, Christian Nebiker, Vincent Ochs, Raoul Droeser, Harriet Louise Walker, Martin Bolli, Beat Müller, Philippe Cattin, Sebastian Manuel Staubli
PURPOSE: Virtual reality (VR) allows for an immersive and interactive analysis of imaging data such as computed tomography (CT) and magnetic resonance imaging (MRI). The aim of this study is to assess the comprehensibility of VR anatomy and its value in assessing resectability of pancreatic ductal adenocarcinoma (PDAC). METHODS: This study assesses exposure to VR anatomy and evaluates the potential role of VR in assessing resectability of PDAC. Firstly, volumetric abdominal CT and MRI data were displayed in an immersive VR environment...
January 22, 2024: International Journal of Computer Assisted Radiology and Surgery
#40
JOURNAL ARTICLE
Takahiro Akahori, Taichi Terai, Minako Nagai, Kota Nakamura, Yuichiro Kohara, Satoshi Yasuda, Yasuko Matsuo, Shunsuke Doi, Takeshi Sakata, Masayuki Sho
AIM: This study aimed to evaluate the prognostic impact of total neoadjuvant therapy (TNT) for borderline resectable pancreatic cancer with arterial involvement (BR-A) pancreatic cancer. METHODS: We analyzed 81 patients initially diagnosed as BR-A who received initial treatments between 2007 and 2021. Among them, 18 patients who received upfront surgery were classified as the UFS group, while 30 patients who were treated with neoadjuvant chemoradiotherapy were classified as the NACRT group...
January 2024: Annals of Gastroenterological Surgery
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