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https://www.readbyqxmd.com/read/29791286/metastatic-pancreatic-cancer-asco-clinical-practice-guideline-update
#1
Davendra P S Sohal, Erin B Kennedy, Alok Khorana, Mehmet S Copur, Christopher H Crane, Ignacio Garrido-Laguna, Smitha Krishnamurthi, Cassadie Moravek, Eileen M O'Reilly, Philip A Philip, Ramesh K Ramanathan, Joseph T Ruggiero, Manish A Shah, Susan Urba, Hope E Uronis, Michelle W Lau, Daniel Laheru
Purpose In 2016, ASCO published a guideline to assist in clinical decision making in metastatic pancreatic cancer for initial assessment after diagnosis, first- and second-line treatment options, palliative and supportive care, and follow-up. The purpose of this update is to incorporate new evidence related to second-line therapy for patients who have experienced disease progression or intolerable toxicity during first-line therapy. Methods ASCO convened an Expert Panel to conduct a systematic review of the literature on second-line therapy published between June 2015 and January 2018...
May 23, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29785074/challenges-in-diagnosis-of-pancreatic-cancer
#2
REVIEW
Lulu Zhang, Santosh Sanagapalli, Alina Stoita
Pancreatic cancer is a growing source of cancer related death, yet has poor survival rates which have not improved in the last few decades. Its high mortality rate is attributed to pancreatic cancer biology, difficulty in early diagnosis and the lack of standardised international guidelines in assessing suspicious pancreatic masses. This review aims to provide an update in the current state of play in pancreatic cancer diagnosis and to evaluate the benefits and limitations of available diagnostic technology...
May 21, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29784432/outcome-quality-standards-in-pancreatic-oncologic-surgery-in-spain
#3
Luis Sabater, Isabel Mora, Juan Manuel Gámez Del Castillo, Javier Escrig-Sos, Elena Muñoz-Forner, Marina Garcés-Albir, Dimitri Dorcaratto, Joaquín Ortega
INTRODUCTION: To establish quality standards in oncologic surgery is a complex but necessary challenge to improve surgical outcomes. Unlike other tumors, there are no well-defined quality standards in pancreatic cancer. The aim of this study is to identify quality indicators in pancreatic oncologic surgery in Spain as well as their acceptable limits of variability. METHODS: Quality indicators were selected based on clinical practice guidelines, consensus conferences, reviews and national publications on oncologic pancreatic surgery between the years 2000 and 2016...
May 18, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29778250/surgical-management-of-intraductal-papillary-mucinous-neoplasm-with-main-duct-involvement-an-international-expert-survey-and-case-vignette-study
#4
Lianne Scholten, Nadine C M van Huijgevoort, Marco J Bruno, Carlos Fernandez-Del Castillo, Sohei Satoi, Alain Sauvanet, Christopher Wolfgang, Paul Fockens, Suresh T Chari, Marco Del Chiaro, Jeanin E van Hooft, Marc G Besselink
BACKGROUND: The risk of invasive cancer in resected intraductal papillary mucinous neoplasm with main pancreatic duct involvement is 33%-60%. Most guidelines, therefore, advise resection of main duct intraductal papillary mucinous neoplasm and mixed type intraductal papillary mucinous neoplasm in surgically fit patients, although advice on the surgical strategy (partial or total pancreatectomy) differs. We performed a survey amongst international experts to guide the design of future studies and help to prepare for a single international set of guidelines...
May 16, 2018: Surgery
https://www.readbyqxmd.com/read/29777519/combination-glucose-lowering-therapy-plans-in-t2dm-case-based-considerations
#5
REVIEW
Lawrence Blonde, Susana Dipp, Daniel Cadena
Type 2 diabetes mellitus (T2DM) is a complex disease, and while lifestyle interventions remain the cornerstone of therapy, most patients will also require pharmacotherapy. Current diabetes treatment guidelines and algorithms recommend an individualized approach to setting glycemic goals and selecting treatment. Although a single antihyperglycemic agent may be appropriate as the initial T2DM pharmacotherapy, the progressive nature of the disease due to declining pancreatic β-cell function will result in the vast majority of T2DM patients eventually requiring two or more antihyperglycemic agents...
May 18, 2018: Advances in Therapy
https://www.readbyqxmd.com/read/29776725/collaterals-management-during-pancreatoduodenectomy-in-patients-with-celiac-axis-stenosis-a-systematic-review-of-the-literature
#6
REVIEW
Francesco Giovanardi, Quirino Lai, Manuela Garofalo, Gabriela A Arroyo Murillo, Eleonore Choppin de Janvry, Redan Hassan, Zoe Larghi Laureiro, Adriano Consolo, Fabio Melandro, Pasquale B Berloco
BACKGROUND/OBJECTIVES: Celiac axis stenosis (CAS) represents an uncommon and typically innocuous condition. However, when a pancreatic resection is required, a high risk for upper abdominal organs ischemia is observed. In presence of collaterals, such a risk is minimized if their preservation is realized. The aim of the present study is to systematically review the literature with the intent to address the routine management of collateral arteries in the case of CAS patients requiring pancreatoduodenectomy...
May 15, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29771771/a-therapeutic-strategy-for-resectable-pancreatic-cancer-based-on-risk-factors-of-early-recurrence
#7
Hiroshi Kurahara, Kosei Maemura, Yuko Mataki, Masahiko Sakoda, Satoshi Iino, Yota Kawasaki, Takaaki Arigami, Shinichiro Mori, Yuko Kijima, Shinichi Ueno, Hiroyuki Shinchi, Shoji Natsugoe
OBJECTIVES: The aim of this study was to identify risk factors for early recurrence and assess the prognostic benefit of neoadjuvant therapy (NAT) for resectable pancreatic cancer. METHODS: Patients with radiographically resectable pancreatic cancer according to the National Comprehensive Cancer Network guidelines were enrolled. We regarded recurrence within 6 months after surgery as early recurrence. RESULTS: This study involved 115 patients (80 who underwent upfront surgery and 35 who received NAT)...
May 15, 2018: Pancreas
https://www.readbyqxmd.com/read/29748190/preventive-medicine-for-von-hippel-lindau-disease-associated-pancreatic-neuroendocrine-tumors
#8
Tobias Krauss, Alfonso Massimiliano Ferrara, Thera P Links, Ulrich Wellner, Irina Bancos, Andrey Kvachenyuk, Karina Villar Gómez de Las Heras, Marina Yukina, Roman Petrov, Garrett Bullivant, Laura von Duecker, Swati S Jadhav, Ursula Ploeckinger, Staffan Welin, Camilla Schalin-Jantti, Oliver Gimm, Marija Pfeifer, Joanne Ngeow, Kornelia Hasse-Lazar, Gabriela Sanso, Xiao-Ping Qi, Umit Ugurlu, Rene Eduardo Diaz, Nelson Wohllk, Mariola Peczkowska, Jens Aberle, Delmar Munir Lourenço, Maria Adelaide Pereira, Maria Candida Barisson Villares Fragoso, Ana O Hoff, Madson Queiroz Almeida, Alice H D Violante, Ana R P Quidute, Zheiwei Zhang, Monica Recasens, Luis Robles Diaz, Tada Kunavisarut, Taweesak Wannachalee, Sirinart Sirinvaravong, Eric Jonasch, Simona Grozinsky-Glasberg, Merav Fraenkel, Dmitry Beltsevich, Viacheslav I Egorov, Dirk Bausch, Matthias Schott, Nikolaus Tiling, Gianmaria Pennelli, Stefan Zschiedrich, Roland Därr, Juri Ruf, Timm Denecke, Karl-Heinrich Link, Stefania Zovato, Ernst von Dobschuetz, Svetlana Yaremchuk, Holger Amthauer, Ozer Makay, Attila Patocs, Martin K Walz, Tobias B Huber, Jochen Seufert, Per Hellman, Raymond H Kim, Ekaterina Kuchinskaya, Francesca Schiavi, Angelica Malinoc, Nicole Reisch, Barbara Jarzab, Marta Barontini, Andrzej Januszewicz, Nalini Shah, William Young, Giuseppe Opocher, Charis Eng, Hartmut P H Neumann, Birke Bausch
Pancreatic neuroendocrine tumors (PanNETs) are rare in von Hippel-Lindau disease (VHL) but cause serious morbidity and mortality. Management guidelines for VHL-PanNETs continue to be based on limited evidence, and survival data to guide surgical management are lacking. We established the European-American-Asian-VHL-PanNET-Registry to assess data for risks for metastases, survival and long-term outcomes to provide best management recommendations. Of 2,330 VHL patients, 273 had a total of 484 PanNETs. Median age at diagnosis of PanNET was 35 years (range 10-75)...
May 10, 2018: Endocrine-related Cancer
https://www.readbyqxmd.com/read/29732686/ringer-s-lactate-vs-normal-saline-in-acute-pancreatitis-a-systematic-review-and-meta-analysis
#9
Umair Iqbal, Hafsa Anwar, Melissa Scribani
INTRODUCTION: Acute Pancreatitis (AP) is one of the most common causes of hospitalization in the United States. Aggressive intravenous hydration with crystalloids is the first step in management, and is associated with improved survival. Guidelines are unclear regarding the choice of crystalloids. Normal saline (NS) is most commonly used, but recent studies have shown Ringer's lactate (RL) to be associated with better outcomes. METHODS: A comprehensive literature review was conducted by searching the Embase, MEDLINE, Pubmed, and Google Scholar databases through December 2017 to identify all studies that compared the use of NS with RL for the management of acute pancreatitis...
May 7, 2018: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/29706823/locally-advanced-carcinosarcoma-of-the-pancreas
#10
Sasha A Still, Carlos R Becerra, Stacia E Clement-Kruzel, Keith M Cavaness
Carcinosarcoma is a rare subtype of pancreatic neoplasm including both carcinomatous and sarcomatous components. Fewer than 30 cases have been reported to the Surveillance, Epidemiology, and End Results Program database. Given such rarity, definitive treatment guidelines are not well defined. We report a case of pancreatic carcinosarcoma diagnosed in our institution, review tumor clinicopathological characteristics, and describe our medical and surgical management strategy.
April 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29706482/pain-in-pancreatic-ductal-adenocarcinoma-a-multidisciplinary-international-guideline-for-optimized-management
#11
REVIEW
Asbjørn M Drewes, Claudia M Campbell, Güralp O Ceyhan, Myriam Delhaye, Pramod K Garg, Harry van Goor, Berta Laquente, Bart Morlion, Søren S Olesen, Vikesh K Singh, Per Sjøgren, Eva Szigethy, John A Windsor, Marina G Salvetti, Rupjyoti Talukdar
Abdominal pain is an important symptom in most patients with pancreatic ductal adenocarcinoma (PDAC). Adequate control of pain is often unsatisfactory due to limited treatment options and significant variation in local practice, emphasizing the need for a multidisciplinary approach. This review contends that improvement in the management of PDAC pain will result from a synthesis of best practice and evidence around the world in a multidisciplinary way. To improve clinical utility and evaluation, the evidence was rated according to the GRADE guidelines by a group of international experts...
April 22, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29705629/method-optimization-for-extracting-high-quality-rna-from-the-human-pancreas-tissue
#12
Eunsung Jun, Juyun Oh, Song Lee, Hye-Ryeong Jun, Eun Hye Seo, Jin-Young Jang, Song Cheol Kim
Nucleic acid sequencing is frequently used to determine the molecular basis of diseases. Therefore, proper storage of biological specimens is essential to inhibit nucleic acid degradation. RNA isolated from the human pancreas is generally of poor quality because of its high concentration of endogenous RNase. In this study, we optimized the method for extracting high quality RNA from paired tumor and normal pancreatic tissues obtained from eight pancreatic cancer patients post-surgery. RNA integrity number (RIN) was checked to evaluate the integrity of RNA, we tried to extract the RNA with an RIN value of 8 or higher that allows for the latest genetic analysis...
April 26, 2018: Translational Oncology
https://www.readbyqxmd.com/read/29698952/combined-systemic-chemotherapy-and-ct-guided-high-dose-rate-brachytherapy-for-isolated-local-manifestation-of-pancreatic-cancer-after-surgical-resection
#13
Caspar Franck, Peter Hass, Peter Malfertheiner, Jens Ricke, Max Seidensticker, Marino Venerito
BACKGROUND: Prospective data on the optimal management of patients with pancreatic ductal adenocarcinoma (PDA) and isolated local manifestation (ILM) after surgery are lacking. Hence, no statements with respect to this entity have been released from most international guidelines including European Society for Medical Oncology, National Comprehensive Cancer Network, and American Society for Clinical Oncology. METHODS: We report for the first time a case-series of 3 patients with PDA and ILM receiving combined systemic chemotherapy and CT-guided high-dose-rate interstitial brachytherapy (CT-HDRBT)...
April 26, 2018: Digestion
https://www.readbyqxmd.com/read/29693234/a-retrospective-analysis-comparing-the-use-of-procore%C3%A2-with-standard-fine-needle-aspiration-in-endobronchial-ultrasound-guided-transbronchial-needle-aspiration-ebus-tbna
#14
David J McCracken, Melanie Bailey, Marie-Therese McDermott, Terence E McManus
Endobronchial ultrasound has become first line in the investigation of mediastinal lesions suspicious for malignancy in keeping with National Institute for Health and Care Excellence (NICE) guidelines; however, needle size and type required to maximise diagnostic sensitivity remains unclear. Previous meta-analyses have compared the use of ProCore with standard fine needle aspiration in the assessment of pancreatic masses with differences noted only in the number of passes required. We aim to assess whether a ProCore needle improves diagnostic sensitivity in EBUS-TBNA...
April 24, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29691733/health-disparities-impact-expected-treatment-of-pancreatic-ductal-adenocarcinoma-nationally
#15
Waseem Lutfi, Mazen S Zenati, Amer H Zureikat, Herbert J Zeh, Melissa E Hogg
BACKGROUND AND PURPOSE: National adherence to treatment guidelines for pancreatic ductal adenocarcinoma (PDAC) is a concern. This study aims to evaluate national expected treatment (ET) adherence for all PDAC stages. We hypothesized that both patient and hospital demographics are associated with national ET disparities for PDAC. METHODS: Clinical stage I through IV PDAC patients were evaluated using the National Cancer Data Base from 2004 to 2013. ET was defined as surgery for stage I/II, chemotherapy or radiation for stage III, and chemotherapy for stage IV...
April 24, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29686710/total-plasma-exchange-in-hypertriglyceridemia-induced-pancreatitis-case-report-and-literature-review
#16
Harleen Dehal, Michael Adashek
Objective: To emphasize the role of apheresis in management of pancreatitis. Methods: The clinical course of a patient admitted for hypertriglyceridemia-induced pancreatitis (HTGP) complicated by multiorgan dysfunction is described, who demonstrated dramatic improvement in his clinical status after total plasma exchange (TPE). In addition, the current guidelines for TPE and the alternative treatment options for HTGP are also presented. Results: A patient presenting with pancreatitis associated with severe systemic inflammatory response was admitted to our hospital with an initial triglyceride level of 1181 mg/dL...
2018: Case Reports in Medicine
https://www.readbyqxmd.com/read/29667626/eus-fna-in-cystic-pancreatic-lesions-where-are-we-now-and-where-are-we-headed-in-the-future
#17
REVIEW
Jose Lariño-Noia, Julio Iglesias-Garcia, Daniel de la Iglesia-Garcia, J Enrique Dominguez-Muñoz
EUS-FNA is often performed in the evaluation of Cystic Pancreatic Lesions (CPL) for a better preoperative characterization. The objective is to identify premalignant lesions as Mucinous Cystic Neoplasms, and/or a malignant transformation of them (adenocarcinoma). The role of cytological evaluation in this setting is discouraging and intracystic markers analysis, mainly CEA, lacks of a good specificity for the detection of mucinous neoplasms. New devices and approaches have emerged to overcome these problems as the cytology brush (Echobrush), the small mini-biopsy foceps, the cystoscopy and the needle Confocal LASER Endomicroscopy (nCLE), showing in some studies good rates of accuracy for distinguishing among mucinosus and non-mucinous neoplasms...
March 2018: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/29667044/germline-variants-in-pancreatic-cancer-patients-with-a-personal-or-family-history-of-cancer-fulfilling-the-revised-bethesda-guidelines
#18
Akihiro Ohmoto, Chigusa Morizane, Emi Kubo, Erina Takai, Hiroko Hosoi, Yasunari Sakamoto, Shunsuke Kondo, Hideki Ueno, Kazuaki Shimada, Shinichi Yachida, Takuji Okusaka
BACKGROUND: Pancreatic cancer (PC) is categorized as a neoplasm associated with Lynch syndrome; however, the precise proportion of PC patients harboring DNA mismatch repair genes (MMR genes) remains unclear, especially in the Asian population. METHODS: Among 304 Japanese patients with pathologically proven pancreatic ductal adenocarcinoma, we selected 20 (6.6%) patients with a personal or family history involving first- or second-degree relatives fulfilling the revised Bethesda guidelines (RBG), defined as RBG-compatible cases...
April 17, 2018: Journal of Gastroenterology
https://www.readbyqxmd.com/read/29667008/eco-friendly-synthesis-in-vitro-anti-proliferative-evaluation-and-3d-qsar-analysis-of-a-novel-series-of-monocationic-2-aryl-heteroaryl-substituted-6-2-imidazolinyl-benzothiazole-mesylates
#19
Livio Racané, Lucija Ptiček, Mirela Sedić, Petra Grbčić, Sandra Kraljević Pavelić, Branimir Bertoša, Irena Sović, Grace Karminski-Zamola
Herein, we describe the synthesis of twenty-one novel water-soluble monocationic 2-aryl/heteroaryl-substituted 6-(2-imidazolinyl)benzothiazole mesylates 3a-3u and present the results of their anti-proliferative assays. Efficient syntheses were achieved by three complementary simple two-step synthetic protocols based on the condensation reaction of aryl/heteroaryl carbaldehydes or carboxylic acid. We developed an eco-friendly synthetic protocol using glycerol as green solvent, particularly appropriate for the condensation of thermally and acid-sensitive heterocycles such as furan, benzofuran, pyrrole, and indole...
April 17, 2018: Molecular Diversity
https://www.readbyqxmd.com/read/29652079/meta-analysis-of-an-artery-first-approach-versus-standard-pancreatoduodenectomy-on-perioperative-outcomes-and-survival
#20
REVIEW
N Ironside, S G Barreto, B Loveday, S V Shrikhande, J A Windsor, S Pandanaboyana
BACKGROUND: The aim of this systematic review and meta-analysis was to evaluate perioperative outcomes and survival in patients undergoing an artery-first approach to pancreatoduodenectomy in comparison with those having standard pancreatoduodenectomy. METHODS: A systematic search of PubMed, MEDLINE, Embase and the Cochrane Database of Systematic Reviews was performed in accordance with PRISMA guidelines. Comparative studies including patients who underwent artery-first pancreatoduodenectomy and standard pancreatoduodenectomy were analysed...
May 2018: British Journal of Surgery
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