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https://www.readbyqxmd.com/read/28646282/surgery-for-pancreatic-ductal-adenocarcinoma
#1
REVIEW
R Vera, L Díez, E Martín Pérez, J C Plaza, A Sanjuanbenito, A Carrato
Surgical resection is the only potentially curative option in the treatment of pancreatic ductal adenocarcinoma. Preoperative radiological imaging allows to rule out the presence of metastases. Three resectability categories are established based on the radiological findings depending on the degree of contact between the tumor and the blood vessels. Histological confirmation of malignancy is only required in cases of borderline or non-resectable tumors, prior to neoadjuvant treatment initiation. Diagnostic laparoscopy is recommended in the presence of large tumors of the body or tail and in borderline tumors to explore the possibility of resection and to apply treatment with curative intent, as well as in those cases with high level of biomarkers to rule out peritoneal involvement...
June 23, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28643308/-anatomical-strategies-of-henle-trunk-in-laparoscopic-right-hemi-colectomy-for-right-colon-cancer
#2
Bo Feng, Xialin Yan, Sen Zhang, Pei Xue, Zirui He, Minhua Zheng
The advancement of laparoscopic surgery serves as a trigger for better understanding of the vascular structure at the inferior border of the pancreas, especially Henle trunk. Henle trunk was first found as convergence to superior mesenteric vein (SMV) conjoined by sub-right colon vein (SRCV) and right gastroepiploic vein (RGEV), but decades later, anterior superior pancreatic duodenal vein (ASPDV) was described as another conjoint vein of Henle trunk. These tributaries are the basic elements of Henle trunk in early years' study...
June 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28643065/laparoscopic-distal-pancreatectomy-for-pancreatic-cancer-is-safe-and-effective
#3
Marita D Bauman, David G Becerra, E Molly Kilbane, Nicholas J Zyromski, C Max Schmidt, Henry A Pitt, Attila Nakeeb, Michael G House, Eugene P Ceppa
PURPOSE: To compare the short-term and oncologic outcomes of patients with pancreatic ductal adenocarcinoma (PDAC) undergoing laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (ODP). METHODS: Consecutive cases of distal pancreatectomy (DP) (n = 422) were reviewed at a single high-volume institution over a 10-year period (2005-2014). Inclusion criteria consisted of any patient with PDAC by surgical pathology. Ninety-day outcomes were monitored through a prospectively maintained pancreatic resection database...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28639725/targeting-nad-p-h-quinone-oxidoreductase-nqo1-in-pancreatic-cancer
#4
Anne M Lewis, Matthew Ough, Juan Du, Ming-Sound Tsao, Larry W Oberley, Joseph J Cullen
Quinone oxidoreductase (NQO1) functions as an important part of cellular antioxidant defense by detoxifying quinones, thus preventing the formation of reactive oxygen species. The aims of our study were to determine if NQO1 is elevated in pancreatic cancer specimens and pancreatic cancer cell lines and if so, would compounds previously demonstrated to redox cycle with NQO1 be effective in killing pancreatic cancer cells. Immunohistochemistry of resected pancreatic specimens demonstrated an increased immunoreactivity for NQO1 in pancreatic cancer and pancreatic intraepithelial neoplasia (PanIN) specimens versus normal human pancreas...
July 2017: Molecular Carcinogenesis
https://www.readbyqxmd.com/read/28639410/long-term-survival-benefit-of-upfront-chemotherapy-in-patients-with-newly-diagnosed-borderline-resectable-pancreatic-cancer
#5
Bikram Shrestha, Yifei Sun, Farzana Faisal, Victoria Kim, Kevin Soares, Alex Blair, Joseph M Herman, Amol Narang, Avani S Dholakia, Lauren Rosati, Amy Hacker-Prietz, Linda Chen, Daniel A Laheru, Ana De Jesus-Acosta, Dung T Le, Ross Donehower, Nilofar Azad, Luis A Diaz, Adrian Murphy, Valerie Lee, Elliot K Fishman, Ralph H Hruban, Tingbo Liang, John L Cameron, Martin Makary, Matthew J Weiss, Nita Ahuja, Jin He, Christopher L Wolfgang, Chiung-Yu Huang, Lei Zheng
The use of neoadjuvant chemotherapy or radiation for borderline resectable pancreatic adenocarcinoma (BL-PDAC) is increasing. However, the impact of neoadjuvant chemotherapy and radiation therapy on the outcome of BL-PDAC remains to be elucidated. We performed a retrospective analysis of 93 consecutive patients who were diagnosed with BL-PDAC and primarily followed at Johns Hopkins Hospital between February 2007 and December 2012. Among 93 patients, 62% received upfront neoadjuvant chemotherapy followed by chemoradiation, whereas 20% received neoadjuvant chemoradiation alone and 15% neoadjuvant chemotherapy alone...
June 21, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28639051/adjuvant-treatment-for-pancreatic-ductal-carcinoma
#6
REVIEW
T Macarulla, T Fernández, M E Gallardo, O Hernando, A M López, M Hidalgo
Pancreatic ductal adenocarcinoma (PDAC) is a tumor with a very poor prognosis. Most of the patients are diagnosed in advanced stages of the disease, and 5-year survival rates in these patients remains <10%. Surgery still remains the only radical treatment option, although only 15-20% of patients are candidates for surgical resection at the time of the diagnosis. Patients who undergo radical surgery still have a limited survival rate, being the average of 23 months. Three clinical trials have shown that adjuvant chemotherapy therapy after surgery may improve survival: CONKO-1, ESPAC-3, and ESPAC-4...
June 21, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28638795/potential-prognostic-biomarkers-in-pancreatic-juice-of-resectable-pancreatic-ductal-adenocarcinoma
#7
REVIEW
Shefali Agrawal
Despite potentially curative surgery pancreatic cancer has a dismal prognosis. Serum cancer antigen 19-9 (CA 19-9) correlates with tumor burden, resectability and survival in patients with pancreatic ductal adenocarcinoma. Identification of novel biomarkers may facilitate early diagnosis of pancreatic cancer and improve survival. Pancreatic juice is a rich source of cancer-specific proteins rendering it a promising tool for identifying biomarkers. Recent proteomic and microRNA expression analyses have identified several biomarkers of potential diagnostic and prognostic value...
June 10, 2017: World Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28638216/role-of-surgery-in-pancreatic-cancer
#8
EDITORIAL
Trond A Buanes
Treatment of pancreatic cancer is multimodal and surgery is an essential part, mandatory for curative potential. Also chemotherapy is essential, and serious postoperative complications or rapid disease progression may preclude completion of multimodal treatment. The sequence of treatment interventions has therefore become an important concern, and numerous ongoing randomized controlled trials compare clinical outcome after upfront surgery and neoadjuvant treatment with subsequent resection. In previous years, borderline resectable and locally advanced pancreatic cancer was most often considered unresectable...
June 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28634843/primary-recurrence-in-the-lung-is-related-to-favorable-prognosis-in-patients-with-pancreatic-cancer-and-postoperative-recurrence
#9
Biao Zheng, Kenoki Ohuchida, Zilong Yan, Takashi Okumura, Takao Ohtsuka, Masafumi Nakamura
BACKGROUND: The pattern of recurrence affects the clinical outcome in tumor patients. However, the clinical significance of lung metastasis as the primary recurrence site after resection in patients with pancreatic cancer remains unclear. This study aimed to clarify the clinical significance of the primary recurrence site in patients with pancreatic cancer, in terms of prognosis and clinicopathological features. METHODS: This retrospective cohort study included 220 patients with postoperative recurrence after pancreatectomy for pancreatic cancer and classified by primary site of recurrence...
June 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28633941/pancreatic-cyst-fluid-vascular-endothelial-growth-factor-a-and-carcinoembryonic-antigen-a-highly-accurate-test-for-the-diagnosis-of-serous-cystic-neoplasm
#10
Rosalie A Carr, Michele T Yip-Schneider, Scott Dolejs, Bradley A Hancock, Huangbing Wu, Milan Radovich, C Max Schmidt
BACKGROUND: Accurate differentiation of pancreatic cystic lesions is important for pancreatic cancer early detection and prevention as well as avoidance of unnecessary surgical intervention. Serous cystic neoplasms (SCN) have no malignant potential, but may mimic premalignant mucinous cystic lesions: mucinous cystic neoplasm (MCN) and intraductal papillary mucinous neoplasm (IPMN). We recently identified vascular endothelial growth factor (VEGF)-A as a novel pancreatic fluid biomarker for SCN...
May 18, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28631202/successful-radical-resection-of-pancreatic-head-carcinoma-in-a-patient-with-replaced-right-hepatic-artery-originating-from-posterior-inferior-pancreaticoduodenal-artery-a-case-report
#11
Yusuke Sakamoto, Takahisa Fujikawa, Akira Tanaka
Anatomical variations of hepatic arteries may be problematic in pancreaticoduodenectomy (PD). We experienced pancreatic head cancer in a patient with rare variation of hepatic artery and performed PD successfully with the resection of this artery. A 75-year-old woman showed pancreatic head tumor on CT. Preoperative CT detected rare variation of hepatic artery; posterior segmental branch of right hepatic artery (RHA-PB) originating from posterior inferior pancreaticoduodenal artery. The image also demonstrated that there was a junction between RHA-PB and anterior branch of right hepatic artery (RHA-AB)...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28631148/early-postoperative-imaging-after-non-bariatric-gastric-resection-a-primer-for-radiologists
#12
REVIEW
Massimo Tonolini, Elena Bracchi
Surgical resection represents the mainstay treatment and only potentially curative option for gastric carcinoma, and is increasingly performed laparoscopically. Furthermore, other tumours and selected cases of non-malignant disorders of the stomach may require partial or total gastrectomy. Often performed in elderly patients, gastric resection remains a challenging procedure, with significant morbidity (14-43% complication rate) and non-negligible postoperative mortality (approximately 3%). This paper provides an overview of contemporary surgical techniques for non-bariatric gastric resection, reviews and illustrates the expected postoperative imaging appearances, common and unusual complications after partial and total gastrectomy...
June 19, 2017: Insights Into Imaging
https://www.readbyqxmd.com/read/28629642/splenic-vein-reconstruction-is-unnecessary-in-pancreatoduodenectomy-combined-with-resection-of-the-superior-mesenteric-vein-portal-vein-confluence-according-to-short-term-outcomes
#13
Haruyoshi Tanaka, Akimasa Nakao, Kenji Oshima, Kiyotsugu Iede, Yukiko Oshima, Hironobu Kobayashi, Yasunori Kimura
BACKGROUND: Superior mesenteric vein-portal vein confluence resection combined with pancreatoduodenectomy (SMPVrPD) is occasionally required for resection of pancreatic head tumors. It remains unclear whether such situations require splenic vein (SV) reconstruction for decompression of left-sided portal hypertension (LSPH). METHODS: The data from 93 of 104 patients who underwent pancreatoduodenectomy (PD) for pancreatic head malignancies were reviewed. Surgical outcomes in three groups-standard PD (control group), PD combined with vascular resection and SV preservation (SVp group), and SMPVrPD with SV resection (SVr group)-were compared...
June 16, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28629416/ct-texture-features-are-associated-with-overall-survival-in-pancreatic-ductal-adenocarcinoma-a-quantitative-analysis
#14
Armin Eilaghi, Sameer Baig, Yucheng Zhang, Junjie Zhang, Paul Karanicolas, Steven Gallinger, Farzad Khalvati, Masoom A Haider
BACKGROUND: To assess whether CT-derived texture features predict survival in patients undergoing resection for pancreatic ductal adenocarcinoma (PDAC). METHODS: Thirty patients with pre-operative CT from 2007 to 2012 for PDAC were included. Tumor size and five texture features namely uniformity, entropy, dissimilarity, correlation, and inverse difference normalized were calculated. Mann-Whitney rank sum test was used to compare tumor with normal pancreas. Receiver operating characteristics (ROC) analysis, Cox regression and Kaplan-Meier tests were used to assess association of texture features with overall survival (OS)...
June 19, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/28628722/microscopic-lymphovascular-invasion-is-an-independent-predictor-of-survival-in-resected-pancreatic-ductal-adenocarcinoma
#15
Jeffrey D Epstein, Geoffrey Kozak, Zhi Ven Fong, Jin He, Ammar A Javed, Upasana Joneja, Wei Jiang, Cristina R Ferrone, Keith D Lillemoe, John L Cameron, Matthew J Weiss, Harish Lavu, Charles J Yeo, Carlos Fernandez-Del Castillo, Christopher L Wolfgang, Jordan M Winter
Background and Objectives Despite routine inclusion of lymphovascular invasion (LVI) status in pathologic reports of resected pancreatic ductal adenocarcinomas (PDA), the clinical implications of LVI have not been well characterized. Methods This study is a retrospective review of 2640 patients who underwent a pancreatectomy for PDA at Thomas Jefferson University Hospital, Massachusetts General Hospital, or Johns Hopkins Hospital (2003-2014). Clinical and pathologic records were extracted from institutional databases...
June 19, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28626371/carcinoma-of-the-papilla-of-vater-after-diversion-operation-for-pancreaticobiliary-maljunction
#16
Takahiro Yamanaka, Kenichiro Araki, Norihiro Ishii, Mariko Tsukagoshi, Takamichi Igarashi, Akira Watanabe, Norio Kubo, Hiroyuki Kuwano, Ken Shirabe
Pancreaticobiliary maljunction (PBM) is a congenital malformation that is associated with biliary cancer development. When patients are diagnosed with PBM, a diversion operation is recommended. Although a risk remains for developing residual bile duct carcinoma following diversion, the development of a carcinoma of the ampulla of Vater after a diversion operation for PBM is rare. We present a treated case of carcinoma of the ampulla of Vater after a diversion operation for PBM. A 65-year-old woman presented with abdominal pain...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626110/-one-case-of-gastric-duplication-cyst-with%C3%A2-ectopic-pancreas-in-adults
#17
Qi Wang, Ziqing Deng, Xiaofeng Yang, Jiaqing Cao
Gastric duplication cyst is a very rare gastrointestinal tract malformation that accounts for 2%-4% of alimentary tract duplications. It is a diagnostic dilemma for doctors because its clinical and radiological manifest is usually nonspecific. At the present stage, it can only rely on surgery. We should pay attention to ectopic pancreas resection and ligation of pancreatic duct during operation. There was one case of gastric duplication cyst with ectopic pancreas in adults from the Second Affiliated Hospital of Nanchang University...
May 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28624798/selection-of-optimal-molecular-targets-for-tumor-specific-imaging-in-pancreatic-ductal-adenocarcinoma
#18
Willemieke Tummers, Arantza Farina Sarasqueta, Martin Boonstra, Hendrica Prevoo, Cornelis Sier, Sven Mieog, Johannes Morreau, Casper van Eijck, Peter Kuppen, Cornelis van de Velde, Bert Bonsing, Alexander Vahrmeijer, Rutger-Jan Swijnenburg
Discrimination of pancreatic ductal adenocarcinoma (PDAC) from chronic pancreatitis (CP) or peritumoral inflammation is challenging, both at preoperative imaging and during surgery, but it is crucial for proper therapy selection. Tumor-specific molecular imaging aims to enhance this discrimination and to help select and stratify patients for resection. We evaluated various biomarkers for the specific identification of PDAC and associated lymph node metastases. Using immunohistochemistry (IHC), expression levels and patterns were investigated of integrin αvβ6, carcinoembryonic antigen-related cell adhesion molecule 5 (CEACAM5), Cathepsin E (Cath E), epidermal growth factor receptor (EGFR), hepatocyte growth factor receptor (c-MET), thymocyte differentiation antigen 1 (Thy1), and urokinase-type plasminogen activator receptor (uPAR)...
May 26, 2017: Oncotarget
https://www.readbyqxmd.com/read/28624178/liver-transplantation-in-patients-with-liver-metastases-from-neuroendocrine-tumors-a%C3%A2-systematic-review
#19
Dimitrios Moris, Diamantis I Tsilimigras, Ioannis Ntanasis-Stathopoulos, Eliza W Beal, Evangelos Felekouras, Spiridon Vernadakis, John J Fung, Timothy M Pawlik
BACKGROUND: Liver transplantation to treat neuroendocrine tumors, especially in the setting of diffuse liver involvement not amenable to operative resection remains controversial. We sought to perform a systematic review of the current literature to summarize data on patients undergoing liver transplantation with neuroendocrine tumors liver metastases as the indication. METHODS: A systematic review was conducted in accordance to the Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines...
June 14, 2017: Surgery
https://www.readbyqxmd.com/read/28621290/efficacy-of-laparoscopic-ultrasonography-in-laparoscopic-resection-of-insulinoma
#20
REVIEW
Mengwei Wu, Huaitao Wang, Xiaobo Zhang, Feng Gao, Peng Liu, Boqiang Yu, Huanbing Qiu, Guanlong Huang, Xiaodong Tan
Insulinoma is the most common functioning islet cell tumor of the pancreas, with an annual incidence of 4 cases/1 million individuals. It is treated by surgical methods. Open surgery was once considered the standard approach for the treatment of insulinoma. However, the procedure is traumatic and requires a large incision, which does not satisfy the growing expectations of minimally invasive management of small-sized tumors. Insulinomas are usually benign solitary tumors and mostly occur sporadically, which makes them suitable candidates for laparoscopic management...
May 2017: Endoscopic Ultrasound
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