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Pancreatic surgery

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https://www.readbyqxmd.com/read/28938270/bariatric-surgery-and-the-risk-of-cancer-in-a-large-multisite-cohort
#1
Daniel P Schauer, Heather Spencer Feigelson, Corinna Koebnick, Bette Caan, Sheila Weinmann, Anthony C Leonard, J David Powers, Panduranga R Yenumula, David E Arterburn
OBJECTIVE: To determine whether bariatric surgery is associated with a lower risk of cancer. BACKGROUND: Obesity is strongly associated with many types of cancer. Few studies have examined the relationship between bariatric surgery and cancer risk. METHODS: We conducted a retrospective cohort study of patients undergoing bariatric surgery between 2005 and 2012 with follow-up through 2014 using data from a large integrated health insurance and care delivery systems with 5 study sites...
September 21, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28933761/neoadjuvant-therapy-of-pancreatic-cancer-definitions-and-benefits
#2
REVIEW
Stefan Heinrich, Hauke Lang
The standard treatment of resectable pancreatic cancer is surgery followed by adjuvant chemotherapy. Due to the complication rate of pancreatic surgery and the high rate of primary irresectability, neoadjuvant concepts are increasingly used for pancreatic cancer. Neoadjuvant therapy is better tolerated than adjuvant and might decrease the surgical complication rate from pancreatic surgery. In contrast to neoadjuvant chemoradiation, the nutritional status improves during neoadjuvant chemotherapy. Also, the survival of patients who develop postoperative complications after neoadjuvant therapy is comparable to those without complications whereas the survival of patients who underwent upfront surgery and then develop surgical complications is impaired...
July 26, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28932629/a-circulating-th2-cytokines-profile-predicts-survival-in-patients-with-resectable-pancreatic-adenocarcinoma
#3
Geny Piro, Francesca Simionato, Carmine Carbone, Melissa Frizziero, Giuseppe Malleo, Silvia Zanini, Raffaella Casolino, Raffaela Santoro, Maria Mihaela Mina, Camilla Zecchetto, Valeria Merz, Aldo Scarpa, Claudio Bassi, Giampaolo Tortora, Davide Melisi
Surgery is the only potentially curative option for patients with pancreatic ductal adenocarcinoma (PDAC), but metastatic relapse remains common. We hypothesized that the expression levels of inflammatory cytokines could predict recurrence of PDAC, thus allowing to select patients who most likely could benefit from surgical resection. We prospectively collected plasma at diagnosis from 287 patients with pancreatic resectable neoplasms. The expression levels of 23 cytokines were measured in 90 patients with PDAC by using a multiplex analyte profiling assay...
2017: Oncoimmunology
https://www.readbyqxmd.com/read/28929779/pancreatic-neuroendocrine-tumors-prognostic-factors
#4
Javier A Cienfuegos, Fernando Rotellar, Miguel Ruiz-Canela
We thank Modesto Varas et al. for their opportune comments with regard to the oncologic outcomes of our series of patients undergoing surgery for pancreatic neuroendocrine tumors (PNET). We agree with Varas et al. in relation to the increase in non-functional tumors (73%) and the incidental form of presentation (44%). These figures are in line with those presented in most series.
September 18, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28927421/a-25-gene-classifier-predicts-overall-survival-in-resectable-pancreatic-cancer
#5
David J Birnbaum, Pascal Finetti, Alexia Lopresti, Marine Gilabert, Flora Poizat, Jean-Luc Raoul, Jean-Robert Delpero, Vincent Moutardier, Daniel Birnbaum, Emilie Mamessier, François Bertucci
BACKGROUND: Pancreatic carcinoma is one of the most lethal human cancers. In patients with resectable tumors, surgery followed by adjuvant chemotherapy is the only curative treatment. However, the 5-year survival is 20%. Because of a strong metastatic propensity, neoadjuvant chemotherapy is being tested in randomized clinical trials. In this context, improving the selection of patients for immediate surgery or neoadjuvant chemotherapy is crucial, and high-throughput molecular analyses may help; the present study aims to address this...
September 20, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28927353/recurrent-metastatic-medullary-thyroid-carcinoma-a-case-of-sustained-response-to-prolonged-treatment-with-somatostatin-analogues
#6
Juana María Cano, Rocío Galán, Rafael López
BACKGROUND: Medullary thyroid carcinoma (MTC) is a rare disease. Treatment options for recurrent disease are limited. Somatostatin analogues might have a role as anticancer agents agents in MTC, although the evidence is inconclusive. PATIENT FINDINGS: A 64-year old male was diagnosed with MTC in January 2010. Total thyroidectomy with neck dissection (stage IVA, pT2pN1bM0, R1) was performed, followed by adjuvant locoregional radiotherapy. Two years later, the patient developed recurrent metastatic disease evidenced by elevated carcinoembryonic antigen (CEA) and calcitonin levels, and a positive uptake (Octreoscan®) in the right adrenal gland and pancreatic head...
September 19, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28927042/surgical-bypass-and-permanent-iodine-125-seed-implantation-vs-surgical-bypass-for-the-treatment-of-pancreatic-head-cancer
#7
Zhenjiang Zheng, Yinglong Xu, Shu Zhang, Guangchun Pu, Chi Cui
The present study aimed to investigate the efficacy and safety of Iodine-125 ((125)I) seed implantation in the treatment of locally advanced unresectable pancreatic head cancer. A prospective nonrandomized study was performed using data collected from patients between January 2009 and December 2012. A total of 34 patients underwent surgical bypass and permanent (125)I seed implantation (group A), and 32 patients underwent biliary and gastric bypass (group B). The preoperative variables, operative data, postoperative complications and follow-up information were examined...
September 2017: Oncology Letters
https://www.readbyqxmd.com/read/28926894/-occurrence-pattern-and-impact-of-lymph-node-micrometastasis-in-pancreatic-head-cancer
#8
Y Zhou, H J Wang
Objective: To investigate the occurrence of lymph node micrometastasis in pancreatic head carcinoma and analyze its effect on the prognosis of patients. Methods: The lymph nodes in 40 patients who received pancreatoduodenectomy with regional lymphadenectomy were dissected by surgical magnification microscopy. The expression of cytokeration(AE1/E3) were detected by immunohistochemical staining in the pathologically negative lymph nodes. The frequency of lymph nodes metastases and micrometastases, as well as the relationship between metastasis and prognosis were analyzed...
September 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28924588/endoscopic-pancreatic-necrosectomy-why-scuff-when-you-can-flush-the-muck-make-it-an-easy-row-to-hoe
#9
Rinkesh Kumar Bansal, Rajesh Puri, Narendra S Choudhary, Sumit Bhatia, Nisharg Patel, Saurabh K Patle, Gaurav K Patil, Amit Agarwal, Chandra Prabha, Randhir Sud
BACKGROUND AND AIMS:  Endoscopic ultrasound (EUS) guided drainage of symptomatic pancreatic walled-off necrosis (WON) followed by fully covered self-expanding metal stent (FCSEMS) placement offers several advantages such as higher technical success rate and the option of necrosectomy. The aim of this study was to evaluate the safety and efficacy of EUS guided drainage of patients with WON by using FCSEMS and intracavitary lavage with a solution containing hydrogen peroxide and adopting a step-up approach...
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28923641/simultaneous-kidney-pancreas-transplantation-with-an-original-transverse-pancreas-technique-initial-9-years-experience-with-56-cases
#10
J Paulino, A Martins, E Vigia, P Marcelino, A M Nobre, L Bicho, E Filipe, E Barroso
An innovative technique for pancreas transplantation is described. The main aspect consists of the horizontal positioning of the pancreas, which allows a better venous outflow, thus preventing thrombosis and graft loss. The program of pancreas transplantation in this national reference center for pancreatic and liver surgery was started in 2007; the initial results were considered poor, resulting in the loss of half of the grafts due to venous thrombosis. After analyzing the possible causes, this technique was proposed and successfully implemented, reducing the postoperative complications, particularly the problem of venous thrombosis...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28922207/sweet-sixteen-the-prospective-clinical-trials-of-john-l-cameron-md-the-clinician-scientist-from-alternate-allocation-to-randomized-controlled-trials
#11
Charles J Yeo
: The era of randomized controlled trials was ushered in by the British epidemiologist-statistician Austin Bradford Hill, with his work on the use of streptomycin in patients with tuberculosis. John L. Cameron, can be linked to 16 prospective clinical trials over his career thus far, starting with alternate-allocation trials and transitioning to prospective, randomized, placebo-controlled trials. These trials studied various topics in surgery-from pancreatitis to surgical site infections, to drain trials, a trial in Crohn disease and multiple trials in pancreatic surgery and cancer...
September 15, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28921102/pancreatic-acinar-cell-carcinoma-with-extensive-tumor-embolism-at-the-trunk-of-portal-vein-and-pancreatic-intraductal-infiltration
#12
Akihiko Kida, Koichiro Matsuda, Kai Takegoshi, Mitsuru Matsuda, Akito Sakai, Yatsugi Noda
A 59-year-old man was admitted to the hospital with acute pancreatitis. The cause was suggested to be a pancreatic tumor based on computed tomography (CT). The pancreatic tumor was 45 mm with an extensive tumor embolism at the trunk of the portal vein and intraductal infiltration of the main pancreatic duct (MPD). The pancreatic tumor was diagnosed as acinar cell carcinoma (ACC) by endoscopic ultrasound guided fine needle aspiration. Therefore, the cause of acute pancreatitis was diagnosed to be intraductal infiltration of ACC in the MPD...
September 18, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28919050/disease-and-treatment-factors-associated-with-lower-quality-of-life-scores-in-adults-with-multiple-endocrine-neoplasia-type-i
#13
Sneha Goswami, Benjamin J Peipert, Irene Helenowski, Susan E Yount, Cord Sturgeon
BACKGROUND: Physical and psychosocial morbidity of multiple endocrine neoplasia type-1 is ill-defined. How disease and treatment-related factors relate to patient-reported outcomes including health-related quality of life is unknown. We hypothesized that disease and treatment burden negatively impacts health-related quality of life in adults with multiple endocrine neoplasia type-1. METHODS: Adults (≥18 years) with multiple endocrine neoplasia type-1 completed an online survey of demographics, disease features, treatments, and Patient-Reported Outcomes Measurement Information System 29-item profile measure, and scores were compared with normative US data...
September 14, 2017: Surgery
https://www.readbyqxmd.com/read/28915662/cbl-b-predicts-postoperative-survival-in-patients-with-resectable-pancreatic-ductal-adenocarcinoma
#14
Qian Dong, Yuteng Ma, Yao Zhang, Xiujuan Qu, Zhi Li, Yafei Qi, Yunpeng Liu, Ce Li, Kai Li, Xianghong Yang, Xiaofang Che
Casitas B-lineage lymphoma b (Cbl-b) is a ubiquitin-protein ligase and a signal transducing adaptor protein involved in immune regulation, and it may be involved in the development and progression of cancer. We investigated the association between Cbl-b expression and prognosis in patients with resectable pancreatic ductal adenocarcinoma (PDAC). The clinicopathological characteristics and survival data of 134 patients with surgery for PDAC between January 2009 and February 2012 were retrospectively evaluated, and Cbl-b expression was assayed by immunohistochemical staining...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28915633/selection-of-optimal-molecular-targets-for-tumor-specific-imaging-in-pancreatic-ductal-adenocarcinoma
#15
Willemieke S Tummers, Arantza Farina-Sarasqueta, Martin C Boonstra, Hendrica A Prevoo, Cornelis F Sier, Jan S Mieog, Johannes Morreau, Casper H van Eijck, Peter J Kuppen, Cornelis J van de Velde, Bert A Bonsing, Alexander L 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)...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28915575/hexokinase-2-promotes-tumor-growth-and-metastasis-by-regulating-lactate-production-in-pancreatic-cancer
#16
Marybeth Anderson, Raoud Marayati, Richard Moffitt, Jen Jen Yeh
Pancreatic ductal adenocarcinoma (PDAC) is a KRAS-driven cancer with a high incidence of metastasis and an overall poor prognosis. Previous work in a genetically engineered mouse model of PDAC showed glucose metabolism to be important for maintaining tumor growth. Multiple glycolytic enzymes, including hexokinase 2 (HK2), were upregulated in primary PDAC patient tumors, supporting a role for glycolysis in promoting human disease. HK2 was most highly expressed in PDAC metastases, suggesting a link between HK2 and aggressive tumor biology...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28914984/hypercalcemic-disorders-in-children
#17
REVIEW
Victoria J Stokes, Morten F Nielsen, Fadil M Hannan, Rajesh V Thakker
Hypercalcemia is defined as a serum calcium concentration that is greater than 2 standard deviations above the normal mean, which in children may vary with age and sex, reflecting changes in the normal physiology at each developmental stage. Hypercalcemic disorders in children may present with hypotonia, poor feeding, vomiting, constipation, abdominal pain, lethargy, polyuria, dehydration, failure to thrive and seizures. In severe cases renal failure, pancreatitis and reduced consciousness may also occur and older children and adolescents may present with psychiatric symptoms...
September 15, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28911286/the-effect-of-a-surgery-specific-cardiac-output-guided-haemodynamic-algorithm-on-outcomes-in-patients-undergoing-pancreaticoduodenectomy-in-a-high-volume-centre-a-retrospective-comparative-study
#18
L Weinberg, J Banting, L Churilov, R L McLeod, K Fernandes, I Chao, T Ho, D Ianno, V Liang, V Muralidharan, C Christophi, M Nikfarjam
In this retrospective observational study performed in a high-volume hepatobiliary-pancreatic unit, we evaluated the effect of a surgery-specific goal-directed therapy (GDT) physiologic algorithm on complications and length of hospital stay. We compared patients who underwent pancreaticoduodenectomy with either a standardised Enhanced Recovery After Surgery program (usual care group), or a standardised Enhanced Recovery After Surgery program in combination with a surgery-specific cardiac output-guided algorithm (GDT group)...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28905804/large-pancreatic-pseudocyst-penetrating-into-posterior-mediastinum
#19
Adam Roman Markowski, Elżbieta Brodalka, Katarzyna Guzinska-Ustymowicz, Konrad Zaręba, Dariusz Cepowicz, Bogusław Kędra
We report a rare case of a large mediastinal pancreatic pseudocyst compressing the left atrium and the esophagus and causing dyspnea, palpitations, and emesis. Chest radiograph was non-diagnostic, esophagogastroduodenoscopy showed diffuse extrinsic compression of the distal esophagus and gastric corpus, but a definitive diagnosis was confirmed by computed tomography. We decided to perform surgery due to the recurrence of the pancreatic pseudocyst, a history of unsuccessful radiologically guided external drainage a few years earlier, and a very large diameter of the pseudocyst causing acute cardio-pulmonary distress syndrome...
August 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28903837/impact-of-different-treatment-modalities-on-the-outcome-of-pancreatic-cancer
#20
Misbah Khan, Muhammad Ijaz Ashraf, Aamir Ali Syed, Faisal Hanif
OBJECTIVE: To analyze overall survival patterns of our pancreatic cancer patient population managed with a curative or palliative intent. STUDY DESIGN: Analytical study. PLACE AND DURATION OF STUDY: Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, from January 2000 till February 2015. METHODOLOGY: Aretrospective review of the data of all of our pancreatic cancer patients was performed, using the hospital information system...
August 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
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