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Pancreatic cancer

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132 papers 25 to 100 followers Pancreatic cancer
Felix J Hüttner, André L Mihaljevic, Thilo Hackert, Alexis Ulrich, Markus W Büchler, Markus K Diener
PURPOSE: Postoperative pancreatic fistula (POPF) is a frequent and clinically relevant problem after distal pancreatectomy. A variety of methods have been tested in the attempt to prevent POPF, most of them without convincing results. METHODS: A systematic literature search was conducted in PubMed, Embase and the Cochrane Library to identify clinical studies comparing pancreatic stump closure with the addition of Tachosil(®) to conventional stump closure. The identified studies were critically appraised, and meta-analyses were performed using a random-effects model...
March 2016: Langenbeck's Archives of Surgery
Mee Joo Kang, Hye Seung Jung, Jin-Young Jang, Woohyun Jung, Jihoon Chang, Yong Chan Shin, Sun-Whe Kim
BACKGROUND: It is considered natural that glucose tolerance worsens after pancreatectomy. However, diabetes mellitus (DM) resolves after metabolic bypass surgery and anatomic changes after PD resemble those after metabolic surgery. This study assessed the incidence of DM resolution after pancreatectomy and differences in metabolic parameters following pancreatoduodenectomy (PD) and distal pancreatectomy (DP). METHODS: Between 2007 and 2013, 218 consecutive patients with pancreatic diseases underwent PD (n = 112) or DP (n = 106) at Seoul National University Hospital...
March 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Bernhard W Renz, Philippe N Khalil, Michael Mikhailov, Sandra Graf, Tobias S Schiergens, Hanno Niess, Stefan Boeck, Volker Heinemann, Werner Hartwig, Jens Werner, Christiane J Bruns, Axel Kleespies
BACKGROUND: The increasing elderly population is an inevitable trend worldwide in developed countries. Therefore, we aimed to assess the experience of a tertiary pancreatic center with a very homogenous population comprising only patients diagnosed with PDAC of the pancreatic head in patients older than 75 years of age compared to their younger counterparts regarding the benefit in life expectancy and tumor biological aggressiveness. METHODS: 300 patients underwent partial pancreaticoduodenectomy (PD) or pylorus preserving pancreaticoduodenectomy (PPPD) for PDAC of the pancreatic head between 2002 and 2012 and were evaluated with regard to their co-morbidities, clinicopathological and perioperative variables, postoperative morbidity, mortality and long term survival...
April 2016: International Journal of Surgery
Haibing Gong, Ruirui Ma, Jian Gong, Chengzong Cai, Zhenshun Song, Bin Xu
Although distal pancreatectomy with en bloc celiac resection (DP-CAR) is used to treat locally advanced pancreatic cancer, the advantages and disadvantages of this surgical procedure remain unclear. The purpose of this study was to evaluate its clinical safety and efficacy.Studies regarding DP-CAR were retrieved from the following databases: PubMed, EMBASE, Web of Science, Cochrane Library, and Chinese electronic databases. Articles were selected according to predesigned inclusion criteria, and data were extracted according to predesigned sheets...
March 2016: Medicine (Baltimore)
R K Ramanathan, D Goldstein, R L Korn, F Arena, M Moore, S Siena, L Teixeira, J Tabernero, J-L Van Laethem, H Liu, D McGovern, B Lu, D D Von Hoff
BACKGROUND: In the phase III MPACT trial, nab-paclitaxel plus gemcitabine (nab-P + Gem) demonstrated superior efficacy versus Gem alone for patients with metastatic pancreatic cancer. We sought to examine the feasibility of positron emission tomography (PET) and to compare metabolic response rates and associated correlations with efficacy in the MPACT trial. PATIENTS AND METHODS: Patients with previously untreated metastatic adenocarcinoma of the pancreas were randomized 1:1 to receive nab-P + Gem or Gem alone...
April 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Woohyung Lee, Yoo-Seok Yoon, Ho-Seong Han, Jai Young Cho, YoungRok Choi, Jae Yool Jang, Hanlim Choi
INTRODUCTION: The prognostic relevance of preoperative diabetes mellitus (DM) on the outcomes of resected pancreatic ductal adenocarcinoma (PDAC) is controversial. Most previous studies evaluated the prognostic role of DM based on a single blood test. METHODS: The participants included 147 patients with PDAC who underwent pancreatectomy between September 2003 and June 2012. They were divided into following groups according to the preoperative DM and degree of hyperglycemia defined by glycosylated hemoglobin (HbA1c): non-DM (n = 70), DM with HbA1c < 9...
February 2016: Journal of Surgical Oncology
Jared Feyko, Hannah Hazard, Jon Cardinal, Alan Thomay, Sung Cho
Chronic renal impairment causes profound physiologic and metabolic changes. Its impact on surgical outcome after pancreatectomy is not well established. We sought to quantify complication rates of pancreatectomy in patients with chronic renal impairment. Database from the American College of Surgeons National Surgical Quality Improvement Project (2005-2011) was queried to identify patients with chronic renal impairment who underwent pancreatectomy. The study population consisted of 16,708 patients of whom 16,649 patients were not on dialysis and 59 patients were on dialysis...
January 2016: American Surgeon
Katherine E Poruk, Vicente Valero, Tyler Saunders, Amanda L Blackford, James F Griffin, Justin Poling, Ralph H Hruban, Robert A Anders, Joseph Herman, Lei Zheng, Zeshaan A Rasheed, Daniel A Laheru, Nita Ahuja, Matthew J Weiss, John L Cameron, Michael Goggins, Christine A Iacobuzio-Donahue, Laura D Wood, Christopher L Wolfgang
OBJECTIVE: We assessed circulating tumor cells (CTCs) with epithelial and mesenchymal phenotypes as a potential prognostic biomarker for patients with pancreatic adenocarcinoma (PDAC). BACKGROUND: PDAC is the fourth leading cause of cancer death in the United States. There is an urgent need to develop biomarkers that predict patient prognosis and allow for better treatment stratification. METHODS: Peripheral and portal blood samples were obtained from 50 patients with PDAC before surgical resection and filtered using the Isolation by Size of Epithelial Tumor cells method...
December 2016: Annals of Surgery
Yasmine Assadipour, Saïd C Azoury, Nicholas N Schaub, Young Hong, Robert Eil, Suzanne M Inchauste, Seth M Steinberg, Aradhana M Venkatesan, Steven K Libutti, Marybeth S Hughes
BACKGROUND: Postoperative pancreatic fistula remains the most severe and worrisome complication after surgery. Predictive preoperative assessment remains challenging. The authors examine the role of pancreatic computed tomography density in predicting postoperative pancreatic fistula after surgery for pancreatic neuroendocrine tumors. METHODS: A single institutional retrospective review of pancreatic surgery for neuroendocrine tumors between 1998 and 2010 was conducted...
July 2016: American Journal of Surgery
N Pecorelli, G Carrara, F De Cobelli, G Cristel, A Damascelli, G Balzano, L Beretta, M Braga
BACKGROUND: Analytical morphometric assessment has recently been proposed to improve preoperative risk stratification. However, the relationship between body composition and outcomes following pancreaticoduodenectomy is still unclear. The aim of this study was to assess the impact of body composition on outcomes in patients undergoing pancreaticoduodenectomy for cancer. METHODS: Body composition parameters including total abdominal muscle area (TAMA) and visceral fat area (VFA) were assessed by preoperative staging CT in patients undergoing pancreaticoduodenectomy for cancer...
March 2016: British Journal of Surgery
H D Heerkens, D S J Tseng, I M Lips, H C van Santvoort, M R Vriens, J Hagendoorn, G J Meijer, I H M Borel Rinkes, M van Vulpen, I Q Molenaar
BACKGROUND: Health-related quality of life (QoL) is of major importance in pancreatic cancer, owing to the limited life expectation. The aim of this prospective longitudinal study was to describe QoL in patients undergoing resection for pancreatic or periampullary malignancy. METHODS: QoL was measured on a scale of 0-100 in patients who underwent pancreatic resection for malignancy or premalignancy at the University Medical Centre Utrecht before resection, and 1, 3, 6 and 12 months after surgery...
February 2016: British Journal of Surgery
M Cesaretti, M Abdel-Rehim, L Barbier, S Dokmak, P Hammel, A Sauvanet
BACKGROUND: In distal pancreatic ductal adenocarcinoma (PDAC), distal pancreatectomy with en bloc splenectomy and celiac axis resection (DP-CAR) can allow curative resection in case of tumor extension to celiac axis. METHODS: From 2008 to 2013, of 102 patients with localized distal PDAC, 7 patients with celiac axis involvement were planned to undergo DP-CAR with curative intent. All patients received neoadjuvant treatment followed by preoperative coil embolization to enlarge collateral arterial pathways, except if a replaced right hepatic artery arising from superior mesenteric artery was present and sufficient for the blood supply...
June 2016: Journal of Visceral Surgery
W Cory Johnston, Helena M Hoen, Maria A Cassera, Pippa H Newell, Chet W Hammill, Paul D Hansen, Ronald F Wolf
BACKGROUND: Total pancreatectomy is infrequently performed for pancreatic cancer. Perceived operative mortality and questionable survival benefit deter many surgeons. Clinical outcomes, described in single-center series, remain largely unknown. METHODS: The National Cancer Database was queried for cases of pancreatic ductal adenocarcinoma undergoing total pancreatectomy (1998-2011). Univariate survival analyses were performed for 21 variables: demographic (8), tumor characteristics (5), surgery outcomes (6), and adjuvant therapy (2)...
January 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Christin Tjaden, Ulf Hinz, Matthias Hassenpflug, Franziska Fritz, Stefan Fritz, Lars Grenacher, Markus W Büchler, Thilo Hackert
BACKGROUND: Fluid collections (FC) at the resection margin of the pancreatic stump after distal pancreatectomy (DP) are common radiological findings in follow-up scans. No recommendations exist regarding the management of such findings. The aim was to characterise incidence, risk factors, clinical impact and therapy of FC. METHOD: Data of 209 patients who underwent DP between 07/2009 and 06/2011 were prospectively collected and analysed, regarding follow-up CT or MRI scan findings of FC at the resection margin...
January 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Alexandra M Roch, Michael G House, Jessica Cioffi, Eugene P Ceppa, Nicholas J Zyromski, Attila Nakeeb, C Max Schmidt
INTRODUCTION: Several studies have confirmed the safety of pancreatoduodenectomy with portal/mesenteric vein resection and reconstruction in select patients. The effect of vein invasion and extent of invasion on survival is less clear. The purpose of this study was to examine the association between tumor invasion of the portal/mesenteric vein and long-term survival. METHODS: A retrospective review of a prospectively maintained database of patients who underwent pancreatoduodenectomy for pancreatic adenocarcinoma at a single academic medical center (2000-2014) was performed...
March 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Masanori Sugiyama, Yutaka Suzuki, Tetsuya Nakazato, Masaaki Yokoyama, Masaharu Kogure, Nobutsugu Abe, Tadahiko Masaki, Toshiyuki Mori
BACKGROUND: In pancreatoduodenectomy (PD), mesopancreas excision with division of the inferior pancreatoduodenal artery (IPDA) is technically difficult because of the complex anatomy resulting from intestinal rotation occurring during embryological development. We have developed an intestinal derotation procedure for facilitating mesopancreas excision. The perioperative factors of PD were retrospectively compared between our derotation and the conventional procedure. METHODS: The entire small intestine and right colon are mobilized from the retroperitoneum, and intestinal rotation is reduced...
May 2016: Surgery
Jose M Pimiento, Ashley H Davis-Yadley, Richard D Kim, Dung-Tsa Chen, Edward A Eikman, Claudia G Berman, Mokenge P Malafa
PURPOSE: Metabolic activity, as defined by F-FDG uptake on PET, is a prognostic marker for multiple malignancies; however, no study has examined the prognostic value of imaging with FDG PET in stage I and II pancreatic cancer. We examined the value of PET FDG uptake in early-stage pancreatic cancer patients. METHODS: We identified patients with early-stage pancreatic cancer (I-II) who had FDG PET scan performed as part of their preoperative evaluation. The patients were divided into either high or low FDG uptake according to the median primary tumor standard uptake value (SUVmax)...
March 2016: Clinical Nuclear Medicine
Joon Seong Park, Doo-Ho Lee, Jin-Young Jang, Youngmin Han, Dong Sup Yoon, Jae Keun Kim, Ho-Seong Han, YooSeok Yoon, DaeWook Hwang, Chang Moo Kang, Ho Kyoung Hwang, Woo Jung Lee, JinSeok Heo, Ye Rim Chang, Mee Joo Kang, Yong Chan Shin, Jihoon Chang, Hongbeom Kim, Woohyun Jung, Sun-Whe Kim
BACKGROUND: We performed a prospective, multicenter, randomized controlled study to investigate the clinical outcomes, including postoperative pancreatic fistulas (POPF), after using the TachoSil® patch in distal pancreatectomy (NCT01550406). METHODS: Between June 2012 and September 2014, 101 patients at five centers were randomized into Control (n = 53) and TachoSil (n = 48) groups. In all patients, the pancreas was resected using a stapler with Endo-GIA™ staples...
February 2016: Journal of Hepato-biliary-pancreatic Sciences
Sohei Satoi, Yoshiaki Murakami, Fuyuhiko Motoi, Masayuki Sho, Ippei Matsumoto, Kenichiro Uemura, Manabu Kawai, Masanao Kurata, Hiroaki Yanagimoto, Tomohisa Yamamoto, Masamichi Mizuma, Michiaki Unno, Shoichi Kinoshita, Takahiro Akahori, Makoto Shinzeki, Takumi Fukumoto, Yasushi Hashimoto, Seiko Hirono, Hiroki Yamaue, Goro Honda, Masanori Kwon
OBJECTIVE: The aim of this study was to reappraise the clinical role of total pancreatectomy with curative intent in patients with pancreatic ductal adenocarcinoma (PDAC). METHODS: In 2001 to 2011 database from 7 institutions in Japan, 45 (3.1%) of 1451 patients with PDAC underwent total pancreatectomy (TP group), and 885 patients underwent pancreaticoduodenectomy (PD group). A matched-pairs group consisted of 45 patients matched for age, sex, year, resectability status, and neoadjuvant therapy (matched-PD group)...
August 2016: Pancreas
Lai Mun Wang, Michael A Silva, Zenobia D'Costa, Robin Bockelmann, Zahir Soonawalla, Stanley Liu, Eric O'Neill, Somnath Mukherjee, W Gillies McKenna, Ruth Muschel, Emmanouil Fokas
Pancreatic ductal adenocarcinoma (PDAC) is characterized by an abundant desmoplastic stroma. We examined the prognostic value of stroma density and activity in patients with resectable PDAC treated with surgery and adjuvant gemcitabine-based chemotherapy. FFPE-tissue from the pancreatectomy of 145 patients was immunohistochemically stained for haematoxylin-eosin and Masson's trichrome to assess stroma density, and alpha-smooth muscle actin (αSMA) expression for activated pancreatic stellate cells. Their expression was correlated with clinicopathological characteristics as well as overall survival (OS), progression-free survival (PFS), local progression-free survival (LPFS) and distant metastases free-survival (DMFS)...
January 26, 2016: Oncotarget
2016-01-12 06:24:03
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