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https://www.readbyqxmd.com/read/28105356/conversion-therapy-for-pancreatic-cancer-with-peritoneal-metastases-using-intravenous-and-intraperitoneal-paclitaxel-with-s-1
#1
Hiromitsu Kitayama, Yasushi Tsuji, Tomohiro Kondo, Junko Sugiyama, Michiaki Hirayama, Kazuyuki Yamamoto, You Kawarada, Yumiko Oyamada, Satoshi Hirano
Combination chemotherapy consisting of systemic and intraperitoneal agents against peritoneal metastases from several types of cancer has shown promising results. We herein report a case in which combination therapy with intravenous and intraperitoneal paclitaxel with S-1 converted an unresectable pancreatic cancer with peritoneal metastases into a resectable one. The patient was a 65-year old woman with recurrent pancreatitis for 5 months. Endoscopic ultrasonography-guided fine-needle aspiration revealed minute epithelial masses composed of cells with irregular nuclei in the pancreatic body...
December 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28105157/prognostic-impact-of-the-tumor-infiltrating-regulatory-t-cell-foxp3-activated-cytotoxic-t-lymphocyte-granzyme-b-ratio-on-resected-left-sided-pancreatic-cancer
#2
Ho Kyoung Hwang, Hyoung-Il Kim, Se Hoon Kim, Junjeong Choi, Chang Moo Kang, Kyung Sik Kim, Woo Jung Lee
Among the subsets of tumor-infiltrating lymphocytes (TILs), activated cytotoxic T lymphocytes (granzyme B(+)) have an antitumor effect, while regulatory T lymphocytes [forkhead box P3 (Foxp3)(+)] suppress the antitumor immune response. The aim of the present study was to investigate the possible associations between TIL subsets and survival outcomes in patients with left-sided pancreatic ductal adenocarcinoma (PDAC). From January 2000 to December 2008, 30 patients who underwent curative distal pancreatectomy without neoadjuvant chemoradiotherapy due to left-sided PDAC were enrolled in the present study...
December 2016: Oncology Letters
https://www.readbyqxmd.com/read/28104143/sinistral-portal-hypertension-after-live-segmental-pancreas-donation-a-long-term-sequelae-presenting-with-life-threatening-upper-gastrointestinal-hemorrhage
#3
O K Serrano, R D Cunha, T Mettler, D E R Sutherland, R Kandaswamy
INTRODUCTION: Variceal hemorrhage from sinistral portal hypertension has never been reported as a complication of live pancreas donation. CASE REPORT: We present a 68-year-old patient who underwent a simultaneous live-donor laparoscopic segmental pancreatectomy and nephrectomy for the purposes of donating to her daughter. Her postoperative course was significant for an episode of acute pancreatitis with a pseudocyst formation. More than a decade later, she presented with variceal hemorrhage from sinistral portal hypertension, which after a diagnostic work-up, prompted a laparoscopic splenectomy...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28101795/locally-advanced-pancreatic-cancer-successfully-treated-by-distal-pancreatectomy-with-celiac-axis-resection-dp-car-after-s-1-with-radiation-therapy-followed-by-gemcitabine-nab-paclitaxel-therapy-a-case-report
#4
Kyohei Ariake, Fuyuhiko Motoi, Masamichi Mizuma, Keigo Murakami, Tatsuyuki Takadate, Hideo Ohtsuka, Koji Fukase, Kunihiro Masuda, Hiroki Hayashi, Kei Nakagawa, Naoaki Sakata, Takanori Morikawa, Shimpei Maeda, Takeshi Naitoh, Shinichi Egawa, Michiaki Unno
BACKGROUND: The prognosis for pancreatic cancer remains dismal because many patients are diagnosed with unresectable cancer at the initial diagnosis. Recently, conversion surgery was reported as an effective treatment for initially unresectable pancreatic cancer with a favorable response to non-surgical treatment lasting over 240 days. Here, we describe a case of locally advanced pancreatic cancer (LAPC) successfully resected after treatment with S-1 and radiation followed by gemcitabine/nab-paclitaxel therapy...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28099344/laparoscopic-total-pancreatectomy-case-report-and-literature-review
#5
Xin Wang, Yongbin Li, Yunqiang Cai, Xubao Liu, Bing Peng
RATIONALE: Laparoscopic total pancreatectomy is a complicated surgical procedure and rarely been reported. This study was conducted to investigate the safety and feasibility of laparoscopic total pancreatectomy. PATIENTS AND METHODS: Three patients underwent laparoscopic total pancreatectomy between May 2014 and August 2015. We reviewed their general demographic data, perioperative details, and short-term outcomes. General morbidity was assessed using Clavien-Dindo classification and delayed gastric emptying (DGE) was evaluated by International Study Group of Pancreatic Surgery (ISGPS) definition...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28099251/utility-of-assessing-the-number-of-mutated-kras-cdkn2a-tp53-and-smad4-genes-using-a-targeted-deep-sequencing-assay-as-a-prognostic-biomarker-for-pancreatic-cancer
#6
Hideyuki Hayashi, Takashi Kohno, Hideki Ueno, Nobuyoshi Hiraoka, Shunsuke Kondo, Motonobu Saito, Yoko Shimada, Hitoshi Ichikawa, Mamoru Kato, Tatsuhiro Shibata, Chigusa Morizane, Yasunari Sakamoto, Kazuaki Shimada, Yoshito Komatsu, Naoya Sakamoto, Takuji Okusaka
OBJECTIVES: KRAS, CDKN2A, TP53, and SMAD4 have been recognized as major driver genes in pancreatic carcinogenesis. We examined somatic mutations in 50 cancer-related genes, including the four above-mentioned driver genes, to identify genomic biomarkers for predicting the outcome of patients with pancreatic cancer. METHODS: Genomic DNA was extracted from fresh-frozen specimens obtained from 100 patients with pancreatic cancer who had undergone a pancreatectomy with curative intent...
January 18, 2017: Pancreas
https://www.readbyqxmd.com/read/28093119/impact-of-minimally-invasive-vs-open-distal-pancreatectomy-on-use-of-adjuvant-chemoradiation-for-pancreatic-adenocarcinoma
#7
Kevin L Anderson, Mohamed A Adam, Samantha Thomas, Sanziana A Roman, Julie A Sosa
BACKGROUND: Published data examining the impact of minimally invasive distal pancreatectomy (MIDP) on survival are generally limited to experiences from high-volume institutions. Our aim was to compare utilization of adjuvant chemoradiation and time from surgery until its initiation following MIDP vs. open surgery (ODP) at a national level. METHODS: Adult patients undergoing distal pancreatectomy for Stage I and II pancreatic adenocarcinoma were identified from the National Cancer Data Base, 2010-2012...
January 7, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28091745/sealing-with-cyanoacrylate-and-a-falciform-patch-cannot-prevent-postoperative-pancreatic-fistula
#8
Laura-Christin Tillmann, Torsten Herzog, Waldemar Uhl, Orlin Belyaev
BACKGROUND: This study aimed to evaluate the effect of a new combined method of covering the pancreatic anastomosis or stump with a cyanoacrylate and a falciform patch (CAFP) on the occurrence of postoperative pancreatic fistula (POPF). METHODS: Patients undergoing a pancreaticoduodenectomy (PD) or a distal pancreatectomy (DP) were recruited over a period of 12 months. The pancreaticojejunostomy in PD and the stump in DP were sealed with cyanoacrylate glue and wrapped in a falciform patch...
January 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28091744/prediction-of-pancreatic-fistula-after-distal-pancreatectomy-based-on-cross-sectional-images
#9
Ye Rim Chang, Jae Seung Kang, Jin-Young Jang, Woo Hyun Jung, Mee Joo Kang, Kyung Bun Lee, Sun-Whe Kim
BACKGROUND: Postoperative pancreatic fistula (POPF) is one of the most common and clinically relevant complications after distal pancreatectomy (DP), occurring in 5-40% of patients. Determining risk factors for this complication may aid in its prevention. This study sought to predict the development of POPF after DP preoperatively and objectively based on radiologic findings. METHODS: This study included 60 patients who underwent DP using a stapler for pancreatic division between June 2011 and January 2013...
January 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28089365/gastric-bleeding-risk-following-spleen-preserving-distal-pancreatectomy-with-excision-of-the-splenic-vessels-a%C3%A2-long-term-follow-up
#10
D Louis, A Alassiri, S Kirzin, S Blaye-Felice, M Chalret du Rieu, C H Julio, E Bloom, L Ghouti, B Pradère, G Portier, N Carrère
BACKGROUND: Spleen-preserving distal pancreatectomy with resection of the splenic vessels (VR-SPDP) is an effective procedure. However, hemodynamic changes in splenogastric circulation may lead to the development of gastric varices (GV) with a risk of gastrointestinal (GI) bleeding. This retrospective study aimed to assess the long-term postoperative clinical follow-up of patients and review the late postoperative abdominal computed tomography (CT) or endoscopic examination. METHODS: From 1988 to 2015, 48 consecutive VR-SPDP for benign or low-grade malignant disease were included...
January 12, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28079662/recognition-of-a-thoracic-epidural-hematoma-in-the-setting-of-transient-paralysis-a-case-report
#11
Beth VanderWielen, Lindsay Rubenstein, Marc Shnider, Cindy Ku, Jason Wakakuwa
A 71-year-old woman on aspirin presented for a distal pancreatectomy, splenectomy, and partial colectomy with a T8/9 epidural catheter placed preoperatively in 3 attempts. Prophylactic 5000 units of subcutaneous heparin were given before the procedure. After catheter removal on postoperative day 2, the patient developed transient bilateral lower extremity paralysis, with near complete recovery within 30 minutes. An urgent MRI revealed a T4-T8 epidural hematoma prompting an emergent T3-T8 laminectomy. This case presentation highlights the need for heightened awareness regarding complications related to neuraxial analgesia in patients receiving unfractionated heparin for thromboembolism prophylaxis with concurrent aspirin use...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28078125/changing-paradigm-in-pancreatic-cancer-from-adjuvant-to-neoadjuvant-chemoradiation
#12
Justin D Anderson, Wen Wan, Brian J Kaplan, Jennifer Myers, Emma C Fields
BACKGROUND: Historically, management of pancreatic cancer has been determined based on whether the tumor was amenable to resection and all patients deemed resectable received curative intent surgery followed by adjuvant therapy with chemotherapy (CT) ± RT. However, patients who undergo resection with microscopic (R1) positive margins have inferior rates of survival. The purpose of this study is to identify patients who have undergone pancreatectomy for pancreatic cancer, determine the surgical margins, types of adjuvant therapies given and patterns of failure...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28076733/pancreatectomy-is-underused-in-nsw-regions-with-low-institutional-surgical-volumes-a-population-data-linkage-study
#13
Nicola Creighton, Richard Walton, David M Roder, Sanchia Aranda, Arthur J Richardson, Neil Merrett, David Currow
OBJECTIVE: To examine differences in the proportions of people diagnosed with pancreatic cancer who underwent pancreatectomy, post-operative outcomes and 5-year survival in different New South Wales administrative health regions of residence. DESIGN, SETTING AND PARTICIPANTS: Retrospective analysis of NSW data on pancreatic cancer incidence and surgery, 2005-2013. MAIN OUTCOME MEASURES: The proportion of newly diagnosed patients with pancreatic cancer who were resected in each region; 90-day post-operative mortality; one-year post-operative survival; 5-year post-diagnosis survival...
January 16, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28070725/type-of-resection-whipple-vs-distal-does-not-affect-the-national-failure-to-provide-post-resection-adjuvant-chemotherapy-in-localized-pancreatic-cancer
#14
John R Bergquist, Tommy Ivanics, Christopher R Shubert, Elizabeth B Habermann, Rory L Smoot, Michael L Kendrick, David M Nagorney, Michael B Farnell, Mark J Truty
INTRODUCTION: Adjuvant chemotherapy improves survival after curative intent resection for localized pancreatic adenocarcinoma (PDAC). Given the differences in perioperative morbidity, we hypothesized that patients undergoing distal partial pancreatectomy (DPP) would receive adjuvant therapy more often those undergoing pancreatoduodenectomy (PD). METHODS: The National Cancer Data Base (2004-2012) identified patients with localized PDAC undergoing DPP and PD, excluding neoadjuvant cases, and factors associated with receipt of adjuvant therapy were identified...
January 9, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28069106/portal-vein-thrombosis-after-reconstruction-in-270-consecutive-patients-with-portal-vein-resections-in-hepatopancreatobiliary-hpb-surgery
#15
Masaru Miyazaki, Hiroaki Shimizu, Masayuki Ohtuka, Atsushi Kato, Hiroyuki Yoshitomi, Katsunori Furukawa, Tsukasa Takayashiki, Satoshi Kuboki, Shigetsugu Takano, Daisuke Suzuki, Taku Higashihara
BACKGROUNDS: This study was aimed to evaluate the occurrence of portal vein thrombosis after portal vein reconstruction. METHODS: The portal veins were repaired with venorrhaphy, end-to-end, patch graft, and segmental graft in consecutive 270 patients undergoing hepato-pancreto-biliary (HPB) surgery. RESULTS: Portal vein thrombosis was encountered in 20 of 163 of end-to-end, 2 of 56 of venorrhaphy, and 2 of 5 of patch graft groups, as compared with 0 of 46 of segmental graft group (p < 0...
December 24, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28069033/preoperative-predictors-for-early-recurrence-of-resectable-pancreatic-cancer
#16
Kohei Nishio, Kenjiro Kimura, Ryosuke Amano, Sadaaki Yamazoe, Go Ohrira, Bunzo Nakata, Kosei Hirakawa, Masaichi Ohira
BACKGROUND: The first-line treatment for resectable pancreatic cancer (RPC) is surgical resection. However, our patients have often experienced early recurrence after curative resection for RPC, with desperately poor prognosis. Some reports indicated that minimally distant metastasis not detected at operation might cause early recurrence. The present study aimed to identify preoperative clinicopathological features of early recurrence after curative resection of RPC. METHODS: Ninety RPC patients who underwent curative resection between 2000 and 2014 at our institution were retrospectively analyzed...
January 10, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28065242/advances-in-glycemic-characteristics-complications-and-treatment-for-patients-undergoing-total-pancreatectomy
#17
Ying Zhou, Wei-Gang Zhao
Total pancreatectomy has been mainly used to treat malignant diseases of the pancreas, di-ffuse ductal involvement, and severe chronic pancreatitis. Patients may develop pancreatic diabetes after the surgery, in whom the glucose levels fluctuate widely and are hard to control, which increases the incidence of recurrent hypoglycemia. Postoperative complications are closely associated with the glucose levels. Thus, tighter glycemic management is essential for increasing the survival of these patients. Few cases have been discribed in China...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28059940/histologic-tumor-grade-and-preoperative-bilary-drainage-are-the-unique-independent-prognostic-factors-of-survival-in-pancreatic-ductal-adenocarcinoma-patients-after-pancreaticoduodenectomy
#18
Nicolás Macías, José M Sayagués, Carmen Esteban, Manuel Iglesias, Luís M González, Jose Quiñones-Sampedro, María L Gutiérrez, Luís A Corchete, Maria M Abad, Oscar Bengoechea, Luís Muñoz-Bellvis
BACKGROUND AND AIM: Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal types of cancer; most patients die during the first 6 months after diagnosis. With a 5% 5-year survival rate, is the fourth leading cause of cancer death in developed countries. In this regard, several clinical, histopathologic and biological characteristics of the disease favoring long-term survival after pancreaticoduodenectomy have been reported to be significant prognostic factors. Despite the availability of this information, there is no consensus about the different prognostic factors reported in the literature, probably due to variations in patient selection, methods, and sample size studied...
January 13, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28054178/hemosuccus-pancreaticus-caused-by-a-mucinous-cystic-neoplasm-of-the-pancreas
#19
Yuri Matsumoto, Hiroshi Miyamoto, Akira Fukuya, Fumika Nakamura, Takahiro Goji, Shinji Kitamura, Tetsuo Kimura, Koichi Okamoto, Masahiro Sogabe, Naoki Muguruma, Mitsuo Shimada, Yoshimi Bando, Tetsuji Takayama
Hemosuccus pancreaticus is a gastrointestinal hemorrhage through the main pancreatic duct. Here, we report a rare case of hemosuccus pancreaticus due to a mucinous cystic neoplasm of the pancreas. A 62-year-old woman who had been followed for a branch duct intraductal papillary mucinous neoplasm visited our emergency room due to severe abdominal pain and bloody discharge. Computed tomography revealed that the pancreatic cyst increased the tension of the wall and a high-density area indicative of bleeding into the cyst was observed...
January 4, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28052102/irreversible-electroporation-of-the-pancreas-using-parallel-plate-electrodes-in-a-porcine-model-a-feasibility-study
#20
Steffi J E Rombouts, Maarten W Nijkamp, Willemijn P M van Dijck, Lodewijk A A Brosens, Maurits Konings, R van Hillegersberg, Inne H M Borel Rinkes, Jeroen Hagendoorn, Fred H Wittkampf, I Quintus Molenaar
BACKGROUND: Irreversible electroporation (IRE) with needle electrodes is being explored as treatment option in locally advanced pancreatic cancer. Several studies have shown promising results with IRE needles, positioned around the tumor to achieve tumor ablation. Disadvantages are the technical difficulties for needle placement, the time needed to achieve tumor ablation, the risk of needle track seeding and most important the possible occurrence of postoperative pancreatic fistula via the needle tracks...
2017: PloS One
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