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endoscopic ultrasound pancreatic cancer

Valerie Gausman, Pujan Kandel, Priscilla A Van Riet, Maria Moris, Maia Kayal, Catherine Do, John M Poneros, Amrita Sethi, Frank G Gress, Beth A Schrope, Lyndon Luk, Elizabeth Hecht, Manol Jovani, Marco J Bruno, Djuna L Cahen, Michael B Wallace, Tamas A Gonda
OBJECTIVES: Our aim was to identify baseline characteristics associated with disease progression and malignant transformation in low-risk suspected intraductal papillary mucinous neoplasms (IPMNs). METHODS: This is a retrospective cohort study of prospectively maintained databases of pancreatic cysts at 3 international, academic institutions. Five hundred fifty-nine adult patients with clinically suspected asymptomatic IPMN evaluated by radiologic studies or endoscopic ultrasound between 2003 and 2013 without worrisome features and under surveillance for 12 months or longer were included...
April 2018: Pancreas
Marc Giovannini
Ultrasound-guided drainage is the first-line modality for drainage of symptomatic of pancreatic fluid collections. In the context of pancreatic cancer, use of multiple double-pigtail plastic stents suffice, with high treatment efficacy. This approach provides similar success rates with low complications and better quality of life compared with surgery. Lumen apposing metallic stents (LAMSs) permit more effective drainage with larger diameter; because of their higher costs than plastic stents, their main role is probably in the context of walled-off necrosis, but the place and the use of LAMS should be studied to avoid and reduce the risks of complications...
April 2018: Gastrointestinal Endoscopy Clinics of North America
Gabriel D Lang, Daniel K Mullady, Dayna S Early, Thomas Hollander, Steven A Edmundowicz, Faris M Murad, Steven M Strasberg, Ryan C Fields, William G Hawkins, Maria B Doyle, William C Chapman, Andrea Wang-Gillam, Vladimir M Kushnir
No abstract text is available yet for this article.
March 2, 2018: Clinical Gastroenterology and Hepatology
(no author information available yet)
No abstract text is available yet for this article.
March 2018: American Journal of Surgery
Yao Pan, Jieyu Chen, Risheng Yu
Pancreatic cancer is a highly malignant tumor and surgical resection is the only curative treatment option. In order to improve the prognosis of patients with pancreatic cancer, it is very important to diagnose and evaluate pancreatic cancer accurately and early. Imaging examinations play an important role in tumor detection, staging and surgical resectability evaluation, which can provide reliable evidences for diagnosis and treatment of pancreatic cancer. At present, the imaging techniques commonly used for diagnosis of pancreatic cancer include conventional ultrasound, endoscopic ultrasonography, PET-CT, multi-detector row CT (MDCT), magnetic resonance imaging (MRI), in which MDCT and MRI are the most widely used...
May 25, 2017: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
Pujan Kandel, Michael B Wallace
Pancreas cancer is a lethal cancer as the majority patients are diagnosed at an advanced incurable stage. Despite improvements in diagnostic modalities and management strategies, including surgery and chemotherapies, the outcome of pancreas cancer remains poor. Endoscopic ultrasound (EUS) is an important imaging tool for pancreas cancer. For decades, resected pancreas cancer and other cancer specimens have been used to identify tissue biomarkers or genomics for precision therapy; however, only 20% of patients undergo surgery, and thus, this framework is not useful for unresectable pancreas cancer...
February 17, 2018: Cancers
Kosuke Minaga, Mamoru Takenaka, Ken Kamata, Tomoe Yoshikawa, Atsushi Nakai, Shunsuke Omoto, Takeshi Miyata, Kentaro Yamao, Hajime Imai, Hiroki Sakamoto, Masayuki Kitano, Masatoshi Kudo
The most common symptom in patients with advanced pancreatic cancer is abdominal pain. This has traditionally been treated with nonsteroidal anti-inflammatory drugs and opioid analgesics. However, these treatments result in inadequate pain control or drug-related adverse effects in some patients. An alternative pain-relief modality is celiac plexus neurolysis, in which the celiac plexus is chemically ablated. This procedure was performed percutaneously or intraoperatively until 1996, when endoscopic ultrasound (EUS)-guided celiac plexus neurolysis was first described...
February 15, 2018: Cancers
Diogo Turiani Hourneaux De Moura, Martin Coronel, Danielle Azevedo Chacon, Ryan Tanigawa, Dalton M Chaves, Sérgio E Matuguma, Marcos E Lera Dos Santos, José Jukemura, Eduardo Guimarâes Hourneaux De Moura
Pancreatic cancer is the second most common malignancy of the gastrointestinal tract in the US, and adenocarcinoma has been identified as the most common type of pancreatic cancer. Different types of pancreatic cancers have been classified: adenocarcinoma, ductal adenosquamous carcinoma, solid pseudopapillary tumors, endocrine neoplasms, acinar cell carcinoma, squamous cell carcinoma, cystic tumors, primary lymphoma of the pancreas, and metastatic lesions of the pancreas. Adenosquamous carcinoma is extremely rare, behave in a very aggressive way and is responsible for the 1 to 4% of the pancreatic exocrine neoplastic lesions...
October 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Andrew Y Wang, Patrick S Yachimski
Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) are the mainstays of interventional endoscopic practice. EUS occupies a central role in the diagnosis of pancreatobiliary neoplasms and offers a platform for a wide range of direct tumor therapies. Initial steps have demonstrated the feasibility of such applications in animal models and pilot studies. Larger clinical trials and incorporation of EUS-based therapies into cooperative cancer studies might demonstrate an impact in the clinical prognosis of patients with pancreatic cancer...
February 16, 2018: Gastroenterology
Francesco Maria Di Matteo, Paola Saccomandi, Margareth Martino, Monica Pandolfi, Margherita Pizzicannella, Valerio Balassone, Emiliano Schena, Claudio Marcello Pacella, Sergio Silvestri, Guido Costamagna
BACKGROUND AND AIMS: Endoscopic ultrasound (EUS) has become an interventional technique in which a needle may be used as a vehicle to deliver therapeutic agents. Laser ablation (LA) has been used to treat many primary and secondary neoplasms. This study aimed to assess the feasibility of EUS-guided LA for unresectable (UR) pancreatic cancer. METHODS: Patients with a stage IIb-III pancreatic cancer underwent EUS-guided LA. All patients were unresponsive to previous chemo-radiotherapy...
February 13, 2018: Gastrointestinal Endoscopy
William Berry, Joanne Lundy, Daniel Croagh, Brendan J Jenkins
Advanced pancreatic cancer (PC) is an aggressive malignancy with few effective therapeutic options. While the evolution of precision medicine in recent decades has changed the treatment landscape in many cancers, at present no targeted therapies are used in the routine management of PC. Only a minority of patients with PC present with surgically resectable disease, and in the remainder obtaining high quality biopsy material for both diagnosis and molecular testing can prove challenging. Endoscopic ultrasound-guided fine needle aspiration (EUS FNA) is a widely used diagnostic procedure in PC, and allows tumour sampling in patients with both early and late stage disease...
January 27, 2018: Cancers
William Berry, Daniel Croagh
Personalising cancer therapy is a way of improving treatment efficacy, by selecting specific treatments for patients with certain molecular changes to their tumour. This requires both molecular material to detect these targets and a preclinical disease model to demonstrate treatment efficacy. In pancreatic cancer this is problematic, as most patients present with advanced disease and are therefore ineligible for surgery. As a result, biological material derived from such patients has been excluded from all preclinical studies in personalised medicine...
2018: Methods in Molecular Biology
Chao Liu, Ligang Wang, Xiangmeng He, Yujun Xu, Dong Lu, Peipei Li, Rongbin Lv, Yong Feng, Ming Liu, Chengli Li
BACKGROUND: Pancreatic carcinoma is a common cause of cancer deaths worldwide. Biopsy is often required for the initial diagnosis of pancreatic masses. Biopsy can be performed endoscopically or percutaneously with computed tomography (CT) and ultrasound (US) guidance. MRI offers many inherent advantages over CT and US. PURPOSE/HYPOTHESIS: To prospectively evaluate the feasibility, accuracy, and safety of MRI-guided percutaneous coaxial cutting needle biopsy of pancreatic lesions using an open 1...
January 10, 2018: Journal of Magnetic Resonance Imaging: JMRI
Sumaira Rashid, Nidhi Singh, Surabhi Gupta, Safoora Rashid, Nandini Nalika, Vikas Sachdev, Chandra Sekhar Bal, Siddhartha Datta Gupta, Shyam S Chauhan, Anoop Saraya
OBJECTIVES: Early detection of pancreatic ductal adenocarcinoma still remains a challenge. Patients with chronic pancreatitis (CP) have a markedly increased risk of pancreatic cancer. Mutations in oncogenes and/or tumor suppressor genes play a role in development of pancreatic ductal adenocarcinoma. This study assessed mutations in KRAS and p53 gene in blood as a screening tool for malignant transformation in CP patients. METHODS: This was a cohort, single-center study including 294 CP patients...
January 5, 2018: Pancreas
Masaya Suenaga, Jun Yu, Koji Shindo, Koji Tamura, Jose Alejandro N Almario, Christopher M Zaykoski, P Dane Witmer, Shah Fesharakizadeh, Michael Borges, Anne Marie Lennon, Eun J Shin, Marcia I Canto, Michael G Goggins
Purpose: The measurement of mutations in pancreatic juice samples collected from the duodenum during endoscopic ultrasound (EUS) may improve the diagnostic evaluation of patients undergoing pancreatic surveillance. Our aim was to evaluate the accuracy of using pancreatic juice mutation concentrations to predict the presence and histologic grade of neoplasia in the pancreas.Experimental Design: Digital next-generation sequencing (NGS) of pancreatic juice DNA using a targeted 12-gene panel was performed on 67 patients undergoing pancreatic evaluation during EUS including patients with pancreatic ductal adenocarcinoma, patients who subsequently underwent pancreatic resection for precursor lesions, patients undergoing surveillance for their familial/inherited susceptibility to pancreatic cancer, and normal pancreas disease controls...
January 4, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Gonçalo Nunes, Hélder Coelho, Marta Patita, Rita Barosa, Pedro Pinto Marques, Lídia Roque Ramos, Maria José Brito, Aurora Tomaz, Jorge Fonseca
The authors describe a 31-year-old man admitted due to progressive weight loss, diarrhea and massive hepatomegaly. Laboratory data showed anemia (haemoglobin 11.7 g/dl), abnormal liver tests (total bilirubin 1.4 g/dl, aspartate aminotransferase 70 U/l, alanine aminotransferase 37 U/l and alkaline phosphatase 520 U/l). Abdominal ultrasound (US) displayed a large heterogeneous liver with a segment IV 25 mm nodule. Magnetic resonance revealed a 4 cm pancreatic tail mass and several liver nodules consistent with metastasis...
December 28, 2017: Clinical Journal of Gastroenterology
Yasuaki Abe, Kenji Kimura, Hiromune Shimamura, Kazunori Takeda, Hiroyoshi Suzuki, Junko Sakurada, Kazuyuki Ishida, Katsuaki Ukai
A 73-year-old man was incidentally diagnosed with a cystic lesion in the pancreatic body. Ultrasonography, abdominal computed tomography, magnetic resonance imaging, endoscopic retrograde cholangiopancreatography, and endoscopic ultrasound were performed, and a nodule was detected in the cystic lesion along with an irregularity of the main pancreatic duct. An initial diagnosis of a mixed-type intraductal papillary mucinous neoplasm was made, and a central pancreatectomy was performed. However, the final diagnosis was altered to non-invasive intraductal papillary mucinous carcinoma (IPMC)...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
William H Sherman, Elizabeth Hecht, David Leung, Kyung Chu
LESSONS LEARNED: There is no presenting parameter that predicts the success of neoadjuvant therapy for pancreatic cancer.Despite the images on scans following neoadjuvant therapy, all patients should be evaluated, because inflammation following radiation therapy (RT) may overstate the extent of tumor and vascular involvement. BACKGROUND: In patients presenting with locally advanced pancreatic adenocarcinoma deemed unresectable by two pancreatic cancer surgeons, we analyzed presenting tumor size, extent of vascular involvement, tumor markers, response to neoadjuvant gemcitabine (G), docetaxel (T), and capecitabine (X) with or without additional chemoradiotherapy with GX on R0 resection rates (≥2 mm margins), and survival...
January 2018: Oncologist
Robert J Torphy, Richard D Schulick
Family history is a significant risk factor for developing pancreatic cancer and this hereditary risk can be secondary to familial cancer predisposition syndromes, hereditary pancreatitis, or familial pancreatic cancer. Certain high-risk individuals are recommended to undergo screening for pancreatic cancer with endoscopic ultrasound or MRI/magnetic resonance retrograde cholangiopancreatography because of the potential to identify and curatively resect precursor lesions. The management of suspicious lesions identified on screening high-risk individuals is also discussed...
February 2018: Surgical Clinics of North America
Rémy Nicolle, Yuna Blum, Laetitia Marisa, Celine Loncle, Odile Gayet, Vincent Moutardier, Olivier Turrini, Marc Giovannini, Benjamin Bian, Martin Bigonnet, Marion Rubis, Nabila Elarouci, Lucile Armenoult, Mira Ayadi, Pauline Duconseil, Mohamed Gasmi, Mehdi Ouaissi, Aurélie Maignan, Gwen Lomberk, Jean-Marie Boher, Jacques Ewald, Erwan Bories, Jonathan Garnier, Anthony Goncalves, Flora Poizat, Jean-Luc Raoul, Veronique Secq, Stephane Garcia, Philippe Grandval, Marine Barraud-Blanc, Emmanuelle Norguet, Marine Gilabert, Jean-Robert Delpero, Julie Roques, Ezequiel Calvo, Fabienne Guillaumond, Sophie Vasseur, Raul Urrutia, Aurélien de Reyniès, Nelson Dusetti, Juan Iovanna
Preclinical models based on patient-derived xenografts have remarkable specificity in distinguishing transformed human tumor cells from non-transformed murine stromal cells computationally. We obtained 29 pancreatic ductal adenocarcinoma (PDAC) xenografts from either resectable or non-resectable patients (surgery and endoscopic ultrasound-guided fine-needle aspirate, respectively). Extensive multiomic profiling revealed two subtypes with distinct clinical outcomes. These subtypes uncovered specific alterations in DNA methylation and transcription as well as in signaling pathways involved in tumor-stromal cross-talk...
November 28, 2017: Cell Reports
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