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Periampullary cancer

Jennifer L Williams, Carmen K Chan, Paul A Toste, Irmina A Elliott, Charles R Vasquez, Dharma B Sunjaya, Eric A Swanson, Jamie Koo, O Joe Hines, Howard A Reber, David W Dawson, Timothy R Donahue
Importance: Patients with periampullary adenocarcinomas have widely variable survival. These cancers are traditionally categorized by their anatomic location of origin, namely, the duodenum, ampulla, distal common bile duct (CBD), or head of the pancreas. However, they can be alternatively subdivided histopathologically into intestinal or pancreaticobiliary (PB) types, which may more accurately estimate prognosis. Objectives: To identify factors associated with survival in patients with periampullary adenocarcinomas and to compare survival between those having intestinal-type or PB-type cancers originating from the duodenum, ampulla, or distal CBD with those having pancreatic ductal adenocarcinoma (PDAC)...
October 12, 2016: JAMA Surgery
Richard J Bold
No abstract text is available yet for this article.
October 12, 2016: JAMA Surgery
Dooin Lee, Jae Hoon Lee, Dongho Choi, Chang Moo Kang, Jae Uk Chong, Song-Chul Kim, Kyeong Geun Lee
BACKGROUND: Stomach cancer is the second most commonly diagnosed cancer in Korea. Although the long-term survival outcome has improved, secondary primary tumors from periampullary regions are increasing inevitably and pancreaticoduodenectomy (PD) following gastrectomy is challenging. This study evaluates the surgical outcomes of PD following gastrectomy and suggests the optimum method for reconstruction. METHODS: Patients who underwent curative PD with a history of gastric resection between 2005 and 2015 were assessed retrospectively...
October 11, 2016: World Journal of Surgery
Marek Sierzega, Łukasz Bobrzyński, Andrzej Matyja, Jan Kulig
BACKGROUND: Most pancreatoduodenectomy resections do not meet the minimum of 12 lymph nodes recommended by the American Joint Committee on Cancer for accurate staging of periampullary malignancies. The purpose of this study was to investigate factors affecting the likelihood of adequate nodal yield in pancreatoduodenectomy specimens subject to routine pathological assessment. METHODS: Six hundred sixty-two patients subject to pancreatoduodenectomy between 1990 and 2013 for pancreatic, ampullary, and common bile duct cancers were reviewed...
2016: World Journal of Surgical Oncology
L B Van Rijssen, N C M van Huijgevoort, R J S Coelen, J A Tol, E B Haverkort, C Y Nio, O R Busch, M G Besselink
BACKGROUND: Body composition measures may predict outcomes of cancer surgery. Whereas low muscle mass shown on preoperative computed tomography (CT) scans has been associated with worse outcomes after surgery for pancreatic cancer, less consideration has been given to low muscle attenuation, reflecting poor muscle quality. Studies relating muscle mass and muscle attenuation with outcomes for patients with periampullary, nonpancreatic cancer are lacking. METHODS: Skeletal muscle mass and attenuation were assessed in 166 consecutive patients undergoing pancreatoduodenectomy (PD) for periampullary, nonpancreatic cancer at a single center between 2000 and 2012...
September 8, 2016: Annals of Surgical Oncology
Domenico Tamburrino, Deniece Riviere, Mohammad Yaghoobi, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: Periampullary cancer includes cancer of the head and neck of the pancreas, cancer of the distal end of the bile duct, cancer of the ampulla of Vater, and cancer of the second part of the duodenum. Surgical resection is the only established potentially curative treatment for pancreatic and periampullary cancer. A considerable proportion of patients undergo unnecessary laparotomy because of underestimation of the extent of the cancer on computed tomography (CT) scanning. Other imaging methods such as magnetic resonance imaging (MRI), positron emission tomography (PET), PET-CT, and endoscopic ultrasound (EUS) have been used to detect local invasion or distant metastases not visualised on CT scanning which could prevent unnecessary laparotomy...
September 15, 2016: Cochrane Database of Systematic Reviews
Mireia M Ginesta, Zamira Vanessa Diaz-Riascos, Juli Busquets, Núria Pelaez, Teresa Serrano, Miquel Àngel Peinado, Rosa Jorba, Francisco Javier García-Borobia, Gabriel Capella, Joan Fabregat
Early detection of pancreatic and periampullary neoplasms is critical to improve their clinical outcome. The present authors previously demonstrated that DNA hypermethylation of adenomatous polyposis coli (APC), histamine receptor H2 (HRH2), cadherin 13 (CDH13), secreted protein acidic and cysteine rich (SPARC) and engrailed-1 (EN-1) promoters is frequently detected in pancreatic tumor cells. The aim of the present study was to assess their prevalence in pancreatic juice of carcinomas of the pancreas and periampullary area...
September 2016: Oncology Letters
Shuichi Fujioka, Takeyuki Misawa, Katsuhiko Yanaga
Positive surgical margin of extrapancreatic nerve plexus (ENP) is a major cause of non-curative resection during pancreaticoduodenectomy (PD) for periampullary carcinoma (PC), which is difficult to detect at the early stage of PD. We describe a novel surgical technique using an isolating tape (iTape)-oriented ENP-first dissection (IOEFD) during PD. The iTape is firstly passed through the retroperitoneal space between ENP and inferior vena cava. Then, the iTape is further extracted from major vessels such as the common hepatic and superior mesenteric artery...
October 2016: Journal of Hepato-biliary-pancreatic Sciences
Yousuke Nakai, Tsuyoshi Hamada, Hiroyuki Isayama, Takao Itoi, Kazuhiko Koike
Patients with periampullary cancer or gastric cancer often develop malignant biliary obstruction (MBO) and gastric outlet obstruction (GOO), and combined MBO and GOO is not rare in these patients. Combined MBO and GOO is classified by its location and sequence, and treatment strategy can be affected by this classification. Historically, palliative surgery, hepaticojejunostomy and gastrojejunostomy were carried out, but the current standard treatment is combined transpapillary stent and duodenal stent placement...
August 23, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Bum Jun Kim, Hyun Joo Jang, Jung Han Kim, Hyeong Su Kim, Jin Lee
Ampullary adenocarcinoma (A-AC) is a rare malignancy arising from the ampulla of Vater. KRAS mutation is detected in 30-40% of patients with A-AC, but its clinical implication and prognostic value are not well described. We conducted this meta-analysis to investigate the association between KRAS mutation and prognosis in patients with A-AC. We searched Pubmed, MEDLINE, EMBASE, and the Cochrane Library databases for articles including following terms in their titles, abstracts, or keywords: 'ampullary or periampullary or ampulla of vater', 'cancer or carcinoma', and 'KRAS'...
August 9, 2016: Oncotarget
Vandana Sandhu, David C Wedge, Inger Marie Bowitz Lothe, Knut Jørgen Labori, Stefan C Dentro, Trond Buanes, Martina L Skrede, Astrid M Dalsgaard, Else Munthe, Ola Myklebost, Ole Christian Lingjærde, Anne-Lise Børresen-Dale, Tone Ikdahl, Peter Van Loo, Silje Nord, Elin H Kure
Despite advances in diagnostics, less than 5% of patients with periampullary tumors experience an overall survival of five years or more. Periampullary tumors are neoplasms that arise in the vicinity of the ampulla of Vater, an enlargement of liver and pancreas ducts where they join and enter the small intestine. In this study, we analyzed copy number aberrations using Affymetrix SNP 6.0 arrays in 60 periampullary adenocarcinomas from Oslo University Hospital to identify genome-wide copy number aberrations, putative driver genes, deregulated pathways, and potential prognostic markers...
September 1, 2016: Cancer Research
Bhanu Jayanand Sunil, Ramakrishnan A Seshadri, S Gouthaman, Rama Ranganathan
PURPOSE: The aim of the study was to analyze the long-term survival and the various prognostic factors that influence overall survival in patients undergoing pancreaticoduodenectomy (PD) with non-pancreatic periampullary carcinomas. METHODS: A retrospective analysis of consecutive patients diagnosed with non-pancreatic periampullary carcinomas who underwent PD at a tertiary cancer center was performed. Univariate analysis of various prognostic factors influencing the disease-free survival (DFS) was performed using log-rank test...
August 3, 2016: Journal of Gastrointestinal Cancer
Hai V Nguyen, Jesse Gore, Xin Zhong, Sudha S Savant, Samantha Deitz-McElyea, C Max Schmidt, Michael G House, Murray Korc
Lymph node involvement in pancreatic adenocarcinoma (PAC) predicts postresection survival, but early lymph node metastasis detection is not easily accomplished. We assessed a panel of microRNAs (miRNAs) in a common hepatic artery lymph node (station 8) that is readily accessible during pancreatoduodenectomy (PD) to determine if increased miRNA levels correlate with postresection recurrence. Station 8 lymph nodes overlying the common hepatic artery collected during PD were assayed for miRNA-10b, miRNA-30c, miRNA-21, and miRNA-155 and cytokeratin-19 (CK19), an epithelial cell marker, using quantitative PCR...
October 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Victoria B Allen, Kurinchi Selvan Gurusamy, Yemisi Takwoingi, Amun Kalia, Brian R Davidson
BACKGROUND: Surgical resection is the only potentially curative treatment for pancreatic and periampullary cancer. A considerable proportion of patients undergo unnecessary laparotomy because of underestimation of the extent of the cancer on computed tomography (CT) scanning. Laparoscopy can detect metastases not visualised on CT scanning, enabling better assessment of the spread of cancer (staging of cancer). This is an update to a previous Cochrane Review published in 2013 evaluating the role of diagnostic laparoscopy in assessing the resectability with curative intent in people with pancreatic and periampullary cancer...
2016: Cochrane Database of Systematic Reviews
Nicola Creighton, Richard Walton, David Roder, Sanchia Aranda, David Currow
OBJECTIVES: Informing cancer service delivery with timely and accurate data is essential to cancer control activities and health system monitoring. This study aimed to assess the validity of ascertaining incident cases and resection use for pancreatic and periampullary cancers from linked administrative hospital data, compared with data from a cancer registry (the 'gold standard'). DESIGN, SETTING AND PARTICIPANTS: Analysis of linked statutory population-based cancer registry data and administrative hospital data for adults (aged ≥18 years) with a pancreatic or periampullary cancer case diagnosed during 2005-2009 or a hospital admission for these cancers between 2005 and 2013 in New South Wales, Australia...
2016: BMJ Open
Lennart B van Rijssen, Poorvi Narwade, Nadine C M van Huijgevoort, Dorine S J Tseng, Hjalmar C van Santvoort, Isaac Q Molenaar, Hanneke W M van Laarhoven, Casper H J van Eijck, Olivier R C Busch, Marc G H Besselink
BACKGROUND: Hepatic-artery and para-aortic lymph node metastases (LNM) may be detected during surgical exploration for pancreatic (PDAC) or periampullary cancer. Some surgeons will continue the resection while others abort the exploration. METHODS: A systematic search was performed in PubMed, EMBASE and Cochrane Library for studies investigating survival in patients with intra-operatively detected hepatic-artery or para-aortic LNM. Survival was stratified for node positive (N1) disease...
July 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Koshi Kumagai, Ioannis Rouvelas, Annika Ernberg, Saga Persson, Apostolos Analatos, Daniela Mariosa, Mats Lindblad, Magnus Nilsson, Weimin Ye, Lars Lundell, Jon A Tsai
PURPOSE: Partial stomach partitioning gastrojejunostomy (PSPGJ) was introduced as a palliative treatment for malignant gastric outlet obstruction (MGO) caused by unresectable gastric or periampullary cancers and suggested to offer advantages over conventional gastrojejunostomy (CGJ) in reducing the risk for delayed gastric emptying (DGE). However, insufficient evidence is available to allow a comprehensive view of the true value of PSPGJ. The present study aimed to show the advantages of PSPGJ in terms of alleviating DGE and improving postoperative recovery compared to CGJ...
September 2016: Langenbeck's Archives of Surgery
Óscar Chapa-Azuela, Jorge Alberto Roldán-García, Jair Díaz-Martínez, Agustín Etchegaray-Dondé
BACKGROUND: Approximately 48,960 people in the USA will be diagnosed with pancreatic cancer in 2015 and 40,560 will die for this reason; in México, the new cases of pancreatic cancer in 2012 were 4,274, with 4,133 deaths presented; survival rate in 5 years goes from 1 to15%. Less than 20% of the cases are considered resectable at the time of diagnosis. The Whipple procedure is currently the only curative treatment option for periampullary cancers since the first communication by Whipple in 1935, and up until now is a common procedure in several reference centres around the world...
June 16, 2016: Cirugia y Cirujanos
S Crippa, R Cirocchi, S Partelli, M C Petrone, F Muffatti, C Renzi, M Falconi, P G Arcidiacono
BACKGROUND: Preoperative biliary drainage (PBD) with stenting increases complications compared with surgery without PBD. Metallic stents are considered superior to plastic stents when considering stent-related complications. Aim of the present systematic review and meta-analysis is to compare the rate of endoscopic re-intervention before surgery and postoperative outcomes of metal versus plastic stents in patients with resectable periampullary or pancreatic head neoplasms. METHODS: We conducted a bibliographic research using the National Library of Medicine's PubMed database, including both randomized controlled trials (RCTs) and non-RCTs...
September 2016: European Journal of Surgical Oncology
Kenji Shimizu, Hiroshi Takamori, Hideo Baba
INTRODUCTION: Malignant duodenal stenosis occurs in patients with advanced periampullary cancer. Insertion of a self-expanding metal stent for the treatment of this condition carries the risk of subsequent perforation of the duodenum. We report successful treatment of duodenal perforation induced by a stent. PRESENTATION OF CASE: An 80-year-old woman suffering from stenosis caused by advanced periampullary cancer underwent metallic stent placement and her symptoms improved...
2016: International Journal of Surgery Case Reports
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