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treatment on pancreatic cancer with hepatic metastases

Martha M Kirstein, Steffen Marquardt, Nils Jedicke, Silke Marhenke, Wolfgang Koppert, Michael P Manns, Frank Wacker, Arndt Vogel
BACKGROUND: Chemosaturation with percutaneous hepatic perfusion (CS-PHP; hepatic CHEMOSAT(®) delivery system; Delcath Systems Inc, USA) is a novel medical device, which delivers high doses of melphalan directly to the liver in patients with primary and secondary liver tumors while limiting systemic toxicity through hemofiltration of the hepatic venous blood. The aim of this study was to analyze the safety and efficacy of the second-generation CS-PHP after 54 treatments at Hannover Medical School, Germany...
June 20, 2017: Journal of Cancer Research and Clinical Oncology
Bernhard W Renz, Stefan Boeck, Falk Roeder, Christoph Trumm, Volker Heinemann, Jens Werner
BACKGROUND: Pancreatic cancer is a highly aggressive malignancy and will become the second leading cause of cancer-related death in the USA and also in Germany by 2030. Furthermore, the majority of patients with pancreatic ductal adenocarcinoma (PDAC) will present with distant metastases, limiting surgical management in this population as there is little evidence available to support surgical or ablative treatment options for advanced-stage disease. However, highly selected patients suffering from synchronous and metachronous oligometastatic PDAC may potentially benefit from a surgical resection with an acceptable morbidity...
March 2017: Visceral Medicine
Andrew C Gordon, Omar M Uddin, Ahsun Riaz, Riad Salem, Robert J Lewandowski
Intra-arterial therapies have high antitumor activity for both primary and secondary hepatic malignancies. Selective infusions allow increased delivery of cytoreductive therapy to the tumor bed while sparing the normal hepatic parenchyma. These therapies are now often applied in the outpatient setting or with short overnight hospital stays and have a growing role in the treatment of liver-dominant disease from metastatic colorectal cancer and from neuroendocrine tumors. Less commonly, intra-arterial therapies are applied to treat secondary hepatic malignancies from breast cancer, melanoma, pancreatic adenocarcinoma, and soft-tissue sarcomas...
June 2017: Seminars in Interventional Radiology
Takahiko Tanigawa, Yasunori Hasuike, Yousuke Akiyama, Ichiro Higuchi, Akira Ishikawa, Sanae Hosomi, Makoto Miyamoto
The patient was a 73-year-old woman who underwent distalpancreatectomy for pancreas tailcancer (T3, N0, M0, stage III ). Hepatic arterialinfusion(HAI)using high-dose 5-fluorouracil(5-FU)(6,000mg/week)was performed 35 days after curative resection to prevent liver metastases. Although chemotherapy with gemcitabine(GEM)was administered for 2 weeks, the patient was aware of a nodule(1 cm in diameter)on the right lower quadrant of the abdomen. Resection of the cutaneous mass was performed and histological findings revealed metastatic adenocarcinoma from the pancreas cancer...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Faidon-Marios Laskaratos, Martin Walker, Keval Naik, Emmanouil Maragkoudakis, Nikolaos Oikonomopoulos, Lee Grant, Tim Meyer, Martyn Caplin, Christos Toumpanakis
BACKGROUND: The antiproliferative activity of octreotide LAR in neuroendocrine tumours (NETs) has been demonstrated by small retrospective studies and confirmed by a prospective phase III trial (PROMID). However, there are limited data about the duration and predictors of response. The aim of our retrospective study was to determine the time to radiological progression (TTRP) of disease and the factors that were associated with better response. METHODS: A total of 254 treatment naïve patients with advanced NETs and positive somatostatin receptor scintigraphy were included...
November 22, 2016: British Journal of Cancer
Eleonora M de Leede, Mark C Burgmans, Ellen Kapiteijn, Gre P M Luyten, Martine J Jager, Fred G J Tijl, Henk H Hartgrink, Dirk J Grünhagen, Joost Rothbarth, Cornelis J H van de Velde, Cornelis Verhoef, Alexander L Vahrmeijer
Uveal melanoma patients have a poor survival after the diagnosis of metastatic disease. Isolated hepatic perfusion (IHP) was developed to treat patients with unresectable metastases confined to the liver. This retrospective analysis focuses on treatment characteristics, complications, toxicity and survival after IHP. Patients with uveal melanoma metastases confined to the liver treated with IHP in two experienced hepato-pancreatic-biliary surgery centres (Erasmus MC Cancer Institute and Leiden University Medical Center) were included...
December 2016: Melanoma Research
Murat Fani Bozkurt, Bilge Volkan Salanci, Ömer Uğur
Intra-arterial radionuclide therapies serve essentially as internal radiation treatment options for both primary and metastatic liver tumors, which imply delivering implantable radioactive microspheres into branches of hepatic arteries that feed liver tumors to provide a high dose of targeted radiation to tumor tissue, while sparing the healthy liver tissue from hazardous effects of radiation. The principle of this therapeutic option depends on the unique preferential arterial supply of malignant liver tumors in contrast with mostly portal venous supply of normal hepatocytes as well as excess amount of arterial neovascularization in the tumor bed...
July 2016: Seminars in Nuclear Medicine
Yusuke Kawashima, Hiroto Ishikawa, Toru Hisaka, Kouji Okuda, Yoshito Akagi
Pancreatic neuroendocrine tumors (P-NETs) are relatively rare. Approximately 50-90% of non-functioning P-NETs are malignant, and the only curative treatment is surgical resection. Liver and lymph node metastases often occur. In Japan, the mTOR inhibitor everolimus is now covered by the national health insurance for treatment of P-NETs, including advanced and unresectable tumors. We present a case of P-NETs with liver metastases seen at our hospital and discuss our treatment strategy for this disease. Patients with tumors≤1 cm receive follow-up observation...
January 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
S Levolger, J L A van Vugt, R W F de Bruin, J N M IJzermans
BACKGROUND: Preoperative risk assessment in cancer surgery is of importance to improve treatment and outcome. The aim of this study was to assess the impact of CT-assessed sarcopenia on short- and long-term outcomes in patients undergoing surgical resection of gastrointestinal and hepatopancreatobiliary malignancies. METHODS: A systematic search of Embase, PubMed and Web of Science was performed to identify relevant studies published before 30 September 2014. PRISMA guidelines for systematic reviews were followed...
November 2015: British Journal of Surgery
Ariel Chami, Benjamin Person, Riad Haddad, Yoav Ben Shahar, Mariana Steiner, Arie Bitterman
INTRODUCTION: There is a continuous rise in the proportion of elderly people in the general population. Previously, old age was a contraindication for numerous medical procedures. AIM: To assess the postoperative outcome of elderly patients who underwent major surgery of the liver, pancreas and stomach. MATERIALS AND METHODS: A retrospective analysis of patients aged 75 and older who underwent elective operations for malignant tumors of the stomach, pancreas and liver between January 2005 and December 2009 in the Department of Surgery A, at Carmel Medical Center...
June 2015: Harefuah
Andrew Kuei, Sammy Saab, Sung-Ki Cho, Stephen T Kee, Edward Wolfgang Lee
The liver is a common site of metastasis, with essentially all metastatic malignancies having been known to spread to the liver. Nearly half of all patients with extrahepatic primary cancer have hepatic metastases. The severe prognostic implications of hepatic metastases have made surgical resection an important first line treatment in management. However, limitations such as the presence of extrahepatic spread or poor functional hepatic reserve exclude the majority of patients as surgical candidates, leaving chemotherapy and locoregional therapies as next best options...
July 21, 2015: World Journal of Gastroenterology: WJG
Masaki Wakasugi, Masahiro Tanemura, Kenta Furukawa, Maiko Murata, Masanori Miyazaki, Masahide Oshita, Ken-Ichi Yoshida, Hironao Yasuoka, Hiroki Akamatsu
INTRODUCTION: Signet ring cell carcinoma (SRCC) of the ampulla of vater is a very rare tumor that is reported infrequently in the literature. PRESENTATION OF CASE: A 59-year-old woman visited our hospital for evaluation of elevated transaminase levels. On laboratory examination of tumor marker levels, carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 levels were normal, and DUPAN-2 was elevated. Computed tomography (CT) confirmed a 2cm, enhanced mass in the periampullary region, with marked common bile duct dilatation...
2015: International Journal of Surgery Case Reports
Masahiro Shinoda, Norihiro Kishida, Osamu Itano, Shigenori Ei, Akihisa Ueno, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Yohei Masugi, Minoru Tanabe, Koichi Aiura, Michiie Sakamaoto, Akihiro Tanimoto, Yuko Kitagawa
An 83-year-old man underwent computed tomography during a routine check-up due to a history of surgical treatment for pancreatic cancer. Two tumors were detected in the anterior segment of the liver. A needle biopsy of the larger tumor was performed, and pathological examination showed that the tumor was a poorly differentiated hepatocellular carcinoma. Resection was not performed considering the patient's poor physical condition. Thus, transcatheter arterial chemoembolization and radiofrequency ablation of the tumors were performed...
2015: World Journal of Surgical Oncology
Anil K Arora
Drug-induced liver injury (DILI) is a common occurrence in clinical practice in the present era because of frequent use of drugs and increase in patients who have increased susceptibility to DILI (because of underlying non-alcoholic steatohepatitis [NASH], chronic hepatitis C, chronic hepatitis B and alcoholic liver disease). DILI is the most common reason for withdrawal of an approved drug from the market. The overall mortality rate among patients hospitalized for DILI is approximately 10%. Erlotinib, a tyrosine kinase inhibitor of epidermal growth factor receptor (EGFR) is indicated for treatment of patients with locally advanced or metastatic non-small cell lung cancer and pancreatic cancer...
June 2011: Journal of Clinical and Experimental Hepatology
Yin Yuan Zheng, Cheng Wu Tang, Yong Qiang Xu, Wen Ming Feng, Ying Bao, Mao Yun Fei
BACKGROUND/AIMS: This study aims to investigate the safety and efficacy of hepatic arterial infusion chemotherapy (HAIC) on liver metastases from pancreatic cancer after pancreatectomy. METHODOLOGY: We randomly assigned 106 patients with pancreatic cancer after pancreatectomy between 2005 and 2010 to receive 2 cycles of HAIC plus 4 cycles of systemic chemotherapy (Combined Therapy) or 6 cycles of systemic chemotherapy alone (Monotherapy). Both the HAIC and systemic chemotherapy regimen consisted of a 5-hour infusion of 5-fluorouracil 1000 mg/m2 on day 1 followed by gemcitabine 800 mg/m2 as an over 30-min infusion on day 1 and day 8...
July 2014: Hepato-gastroenterology
Yin Yuan Zheng, Cheng Wu Tang, Yong Qiang Xu, Wen Ming Feng, Ying Bao, Mao Yun Fei
BACKGROUND/AIMS: This study aims to investigate the safety and efficacy of hepatic arterial infusion chemotherapy (HAIC) on liver metastases from pancreatic cancer after pancreatectomy. METHODOLOGY: We randomly assigned 106 patients with pancreatic cancer after pancreatectomy between 2005 and 2010 to receive 2 cycles of HAIC plus 4 cycles of systemic chemotherapy (Combined Therapy) or 6 cycles of systemic chemotherapy alone (Monotherapy). Both the HAIC and systemic chemotherapy regimen consisted of a 5-hour infusion of 5-fluorouracil 1000 mg/m2 on day 1 followed by gemcitabine 800 mg/m2 as an over 30-min infusion on day 1 and day 8...
July 2014: Hepato-gastroenterology
Paul Zarogoulidis, Paschalis Pavlioglou, Patrick Le Pivert, Nikolaos Machairiotis, Nikolaos Katsikogiannis, Ioanna Kougioumtzi, Konstantinos Tsimogiannis, Stylianos Kakolyris, Nikolaos Courcoutsakis, Theodora Tsiouda, Antonios Sakkas, Dimitra Makrantonaki, Konstantinos Zarogoulidis
Pancreatic cancer is an insidious type of cancer with its symptoms manifested upon extensive disease. The overall 5-year survival rates between 0.4 and 4%. Surgical resection is an option for only 10% of the patients with pancreatic cancer. Local recurrence and hepatic metastases occur within 2 years after surgery. There are currently several molecular pathways investigated and novel targeted treatments are on the market. However; the nature of pancreatic cancer with its ability to spread locally in the primary site and lymph nodes indicates that further experimentation with local interventional therapies could be a future treatment proposal as palliative care or adjunct to gene therapy and chemotherapy/radiotherapy...
August 2014: Therapeutic Delivery
Xiaolong Tang, Jianwei Zhang, Yingtai Chen, Xu Che, Chengfeng Wang
OBJECTIVE: To summarize the institutional experiences of diagnosis, treatment and prognosis for solid-pseudopapillary carcinoma of the pancreas (SPCP). METHODS: Retrospective analyses were performed for 11 cases of SPCP diagnosed in recent 15 years at Department of Abdominal Surgery, Cancer Institute and Hospital, Chinese Academy of Medical Sciences. RESULTS: There were 10 females and 1 male with an average age of 33 years. The locations included head (n = 7) and body and tail (n = 4)...
January 14, 2014: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Josep Tabernero, Maria Elena Elez, Maria Herranz, Isabel Rico, Ludmila Prudkin, Jordi Andreu, Jose Mateos, Maria Josep Carreras, May Han, James Gifford, Marc Credi, Wei Yin, Shefali Agarwal, Philip Komarnitsky, Jose Baselga
PURPOSE: This study evaluated the safety, tolerability, pharmacodynamics, pharmacokinetics, and antitumor activity of ficlatuzumab, a humanized hepatocyte growth factor (HGF) inhibitory monoclonal antibody, as monotherapy in patients with advanced solid tumors and liver metastases. PATIENTS AND METHODS: Patients with p-Met (phosphorylated c-Met)-positive tumors enrolled in three dose-escalation cohorts, receiving ficlatuzumab 2, 10, or 20 mg/kg once per 14-day cycle...
May 15, 2014: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
M Czejka, A Sahmanovic, P Buchner, T Steininger, C Dittrich
Erlotinib is an oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor approved for the treatment of non-small cell lung cancer and when combined with gemcitabine for pancreatic cancer. Dose reduction of erlotinib in patients with severe hepatic impairment has been established. We present the case of a male patient suffering from an adenocarcinoma of the pancreas with metastases in the liver and lung, whose disease progression led to highly elevated bilirubin levels of >14 mg/dl accompanied by icterus and pruritus...
September 2013: Case Reports in Oncology
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