المؤلفون: Yasuhide Yamada

المصدر: Glob Health Med

مصطلحات موضوعية: Resectable Pancreatic Cancer, Oncology, medicine.medical_specialty, business.industry, Internal medicine, Perioperative chemotherapy, Perspective (graphical), medicine, Review, business

الوصف: Adjuvant chemotherapy is the standard treatment for patients with resectable pancreatic ductal carcinoma. Perioperative chemotherapy has been given in less than 50% of patients with potentially resectable pancreatic cancer in Japan. A modified combination regimen of 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin (mFOLFIRINOX; oxaliplatin 85 mg/m(2), leucovorin 400 mg/m(2), irinotecan 150 mg/m(2) on day 1, and 5-fluorouracil 2,400 mg/m(2) over 46 hours every 14 days for 12 cycles) is now preferred worldwide because it mitigates concerns regarding toxicity and tolerance. Adjuvant chemotherapeutic regimens employ S-1 in East Asia, whereas other areas use FOLFIRINOX, capecitabine plus gemcitabine, or gemcitabine monotherapy. Adjuvant chemoradiotherapy is not recommended because randomized controlled trials and meta-analyses revealed no survival benefit compared with chemotherapy. Preoperative chemotherapy with S-1 and gemcitabine combination chemotherapy for patients with resectable/borderline resectable pancreatic cancer significantly increased survival compared to upfront surgery in a recent clinical trial. Perioperative outcomes, including R0 resection rate and post-operative morbidity, were not significantly different between groups. When compared to upfront surgery, neoadjuvant S-1 and gemcitabine treatment significantly reduced the number of pathological nodal metastases in patients who underwent resection. Japanese guidelines therefore recommend neoadjuvant chemotherapy for patients with resectable pancreatic cancer. Preoperative chemotherapy can increase R0 cases by down-staging with higher relative dose intensity of chemotherapy. In contrast, patients who do not respond to chemotherapy may miss resection opportunities and would therefore be at a disadvantage. Therefore, it is critical for both patients and doctors that predictive markers for the response to chemotherapy are identified.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::747ca565d03e6abc4b9aa5d6e42b485cTest
https://pubmed.ncbi.nlm.nih.gov/35291202Test

المؤلفون: Yoon Suk Lee

المصدر: The Korean Journal of Gastroenterology, Vol 75, Iss 4, Pp 228-230 (2020)

مصطلحات موضوعية: Resectable Pancreatic Cancer, Oncology, medicine.medical_specialty, Preoperative chemoradiotherapy, Survival benefit, business.industry, Internal medicine, lcsh:R, lcsh:Medicine, Medicine, General Medicine, business, Lead (electronics)

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6e60c739147622d2689f122f09e42544Test
https://doi.org/10.4166/kjg.2020.75.4.228Test

المؤلفون: Mariko Tsukagoshi, Kenichiro Araki, Norifumi Harimoto, Akira Watanabe, Ken Shirabe, Ryou Muranushi, Norihiro Ishii, Takahiro Yamanaka, Norio Kubo, Kei Hagiwara, Takamichi Igarashi, Kouki Hoshino

المصدر: Pancreas. 49:e36-e38

مصطلحات موضوعية: Male, Resectable Pancreatic Cancer, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Kaplan-Meier Estimate, Gastroenterology, Fibrin Fibrinogen Degradation Products, Pancreatectomy, Postoperative Complications, Endocrinology, Internal medicine, D-dimer, Biomarkers, Tumor, Internal Medicine, medicine, Hepatectomy, Humans, Postoperative Period, Aged, Proportional Hazards Models, Retrospective Studies, Hepatology, business.industry, Liver Neoplasms, Venous Thromboembolism, Hospital Records, Prognosis, Progression-Free Survival, Neoplasm Proteins, Pancreatic Neoplasms, Pancreatitis, Female, Neoplasm Recurrence, Local, business, Carcinoma, Pancreatic Ductal

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::be389c874b4706b48e0dc9a4570f6514Test
https://doi.org/10.1097/mpa.0000000000001537Test

المؤلفون: Birrer D. L., Golcher H., Casadei R., Haile S. R., Fritsch R., Hussung S., Brunner T. B., Fietkau R., Meyer T., Grutzmann R., Merkel S., Ricci C., Ingaldi C., Di Marco M., Guido A., Serra C., Minni F., Pestalozzi B., Petrowsky H., Deoliveira M., Bechstein W. O., Bruns C. J., Oberkofler C. E., Puhan M., Lesurtel M., Heinrich S., Clavien P. -A.

المساهمون: Birrer D.L., Golcher H., Casadei R., Haile S.R., Fritsch R., Hussung S., Brunner T.B., Fietkau R., Meyer T., Grutzmann R., Merkel S., Ricci C., Ingaldi C., Di Marco M., Guido A., Serra C., Minni F., Pestalozzi B., Petrowsky H., Deoliveira M., Bechstein W.O., Bruns C.J., Oberkofler C.E., Puhan M., Lesurtel M., Heinrich S., Clavien P.-A.

مصطلحات موضوعية: Neoadjuvant chemotherapy/radiochemotherapy, Pancreatic resection, Pancreaticoduodenectomy, Resectable pancreatic cancer

الوصف: Objective: The aim of this study was to pool data from randomized controlled trials (RCT) limited to resectable pancreatic ductal adenocarcinoma (PDAC) to determine whether a neoadjuvant therapy impacts on disease-free survival (DFS) and surgical outcome.Summary Background Data: Few underpowered studies have suggested benefits from neoadjuvant chemo (± radiation) for strictly resectable PDAC without offering conclusive recommendations.Methods: Three RCTs were identified comparing neoadjuvant chemo (± radio) therapy vs. upfront surgery followed by adjuvant therapy in all cases. Data were pooled targeting DFS as primary endpoint, whereas overall survival (OS), postoperative morbidity, and mortality were investigated as secondary endpoints. Survival endpoints DFS and OS were compared using Cox proportional hazards regression with study-specific baseline hazards.Results: A total of 130 patients were randomized (56 in the neoadjuvant and 74 in the control group). DFS was significantly longer in the neoadjuvant treatment group compared to surgery only [hazard ratio (HR) 0.6, 95% confidence interval (CI) 0.4-0.9] (P = 0.01). Furthermore, DFS for the subgroup of R0 resections was similarly longer in the neoadjuvant treated group (HR 0.6, 95% CI 0.35-0.9, P = 0.045). Although postoperative complications (Comprehensive Complication Index, CCI®) occurred less frequently (P = 0.008), patients after neoadjuvant therapy experienced a higher toxicity, but without negative impact on oncological or surgical outcome parameters.Conclusion: Neoadjuvant therapy can be offered as an acceptable standard of care for patients with purely resectable PDAC. Future research with the advances of precision oncology should now focus on the definition of the optimal regimen.

وصف الملف: ELETTRONICO

العلاقة: info:eu-repo/semantics/altIdentifier/wos/WOS:000747387500020; volume:274; issue:5; firstpage:713; lastpage:720; numberofpages:8; journal:ANNALS OF SURGERY; http://hdl.handle.net/11585/857856Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85118283503

الإتاحة: https://doi.org/10.1097/SLA.0000000000005126Test
http://hdl.handle.net/11585/857856Test

المؤلفون: Tao Zhang, Pu Shen, Kai-Jun Huang, Chuan-Zhao Zhang, Li Xiao

المصدر: World Journal of Meta-Analysis. 7:309-322

مصطلحات موضوعية: Resectable Pancreatic Cancer, medicine.medical_specialty, business.industry, Neoadjuvant treatment, Meta-analysis, medicine.medical_treatment, Medicine, business, Adjuvant, Surgery

الوصف: Surgery with adjuvant or neoadjuvant treatment vs surgery alone for resectable pancreatic cancer: A network meta-analysis

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::6f204d7754b9b6124c1fcc682fda1b3aTest
https://doi.org/10.13105/wjma.v7.i6.309Test

المؤلفون: Omeed Moaven, Sushanth Reddy, Joshua S. Richman, Thomas N. Wang, Carlo M. Contreras, Martin J. Heslin

المصدر: The American Journal of Surgery. 217:725-731

مصطلحات موضوعية: Adult, Male, Resectable Pancreatic Cancer, medicine.medical_specialty, Ethnic group, Adenocarcinoma, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Outcome Assessment, Health Care, Tumor stage, Health care, medicine, Humans, Healthcare Disparities, Location, Aged, Retrospective Studies, Tumor size, business.industry, General Medicine, Middle Aged, medicine.disease, United States, Health equity, Pancreatic Neoplasms, Survival Rate, Socioeconomic Factors, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, Surgery, business

الوصف: Background The aim of this study was to evaluate health disparities in the outcomes of patients with resectable pancreatic adenocarcinoma. Methods We retrospectively analyzed 280,935 patients from the National Cancer Data Base (NCDB), from 1998 to 2012 to compare the differences in patient characteristics, refusal of offered surgical treatment and overall survival after pancreatic adenocarcinoma resection between white vs. black patients. Results Black patients did not undergo and refused offered surgical treatment more frequently. Race and insurance were the most important factors independently associated with not receiving the offered resection. Having private insurance, Hispanic ethnic background, geographic location, higher income, residing in urban/metropolitan area and systemic treatment were independently associated with improved survival. Race was associated with overall worse survival in an unadjusted model but not in multivariable analysis. The association between race and survival was removed when adjusting for facility location, income, education, tumor size, tumor stage or systemic treatment. Conclusion Disparities exist at various levels in resectable pancreatic cancers. These findings help developing targeted interventions and quality improvement initiatives.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9bfce8c1f0f2b85eb2e66741efaaee8eTest
https://doi.org/10.1016/j.amjsurg.2018.12.007Test

المؤلفون: Xiaohan Ren, Feng Qi, Xin Hu, Yundi Zhang, Xiao Li, Yichao Ding, Xiyi Wei, Chao Qin

المصدر: OncoTargets and Therapy. 12:733-744

مصطلحات موضوعية: 0301 basic medicine, Resectable Pancreatic Cancer, medicine.medical_specialty, Funnel plot, business.industry, medicine.medical_treatment, Publication bias, Surgery, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Oncology, Nat, 030220 oncology & carcinogenesis, Meta-analysis, medicine, Pharmacology (medical), business, Adjuvant, Survival analysis, Neoadjuvant therapy

الوصف: Objective The role of neoadjuvant therapy (NAT) in resectable pancreatic cancer (RPC) remains controversial. Therefore, this meta-analysis was performed to compare the clinical differences between NAT and upfront surgery in RPC. Materials and methods A systematic literature search was performed in PubMed, Embase, Web of Science, and the Cochrane Register of Controlled Trials databases. Only patients with RPC who underwent tumor resection and received adjuvant or neoadjuvant treatment were enrolled. The OR or HR and 95% CIs were calculated employing fixed-effects or random-effects models. The HR and its 95% CI were extracted from each article that provided survival curve. Publication bias was estimated using funnel plots and Egger's regression test. Results In total, eleven studies were included with 9,386 patients. Of these patients, 2,508 (26.7%) received NAT. For patients with RPC, NAT resulted in an increased R0 resection rate (OR=1.89; 95% CI=1.26-2.83) and a reduced positive lymph node rate (OR=0.34; 95% CI=0.31-0.37) compared with upfront surgery. Nevertheless, patients receiving NAT did not exhibit a significantly increased overall survival (OS) time (HR=0.91; 95% CI=0.79-1.05). Conclusion In patients with RPC, R0 resection rate and positive lymph node rate after NAT were superior to those of patients with upfront surgery. The NAT group exhibited no significant effect on OS time when compared with the upfront surgery group. However, this conclusion requires more clinical evidence to improve its credibility.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::155d2529422c4db54cc484cec8b2b35fTest
https://doi.org/10.2147/ott.s190810Test

المؤلفون: Marek Durlik, Julia Tuchalska-Czuroń, Justyna Augustyniak, Jacek Lenart

المصدر: Pancreatology. 19:73-79

مصطلحات موضوعية: Adult, Genetic Markers, Male, Resectable Pancreatic Cancer, Mitochondrial DNA, Pancreatic ductal adenocarcinoma, DNA Copy Number Variations, Endocrinology, Diabetes and Metabolism, DNA, Mitochondrial, 03 medical and health sciences, 0302 clinical medicine, Pancreatic cancer, Overall survival, Humans, Medicine, Prospective cohort study, Aged, Aged, 80 and over, Hepatology, business.industry, Pancreatic tissue, Gastroenterology, Middle Aged, Prognosis, medicine.disease, Pancreatic Neoplasms, Real-time polymerase chain reaction, 030220 oncology & carcinogenesis, Cancer research, Female, 030211 gastroenterology & hepatology, business

الوصف: The aim of this prospective study was to investigate mitochondrial DNA (mtDNA) copy number in a group of resectable pancreatic cancer (PC) tumor tissues and adjacent normal pancreatic tissues, and to explore the correlation between the mtDNA content in tissues and the clinicopathological parameters and the overall survival.Relative mtDNA copy number was measured by the quantitative PCR-based assay. The tumors specimens (n = 43) originated from the patients with pathologically confirmed pancreatic ductal adenocarcinoma who did not receive any neoadjuvant systemic therapy. The adjacent normal pancreatic tissue samples (n = 31) were obtained from surgical margins.mtDNA copy number was significantly lower in PC tissue (P 0.001) compared to adjacent normal pancreatic tissue. Jonckheere-Terpstra trend testing indicated a statistically significant decrease in median mtDNA copy number across the differentiation (adjacent normal pancreatic tissue, low-grade, intermediate-grade, high-grade cancer), P 0.001. However, the survival analyses failed to show a significant difference in survival between patients with high and low mtDNA copy number.To the best of our knowledge, we provided the first evidence that mitochondrial DNA copy number was significantly lower in pancreatic cancer tissue (P 0.001) compared to adjacent normal pancreatic tissue. Also, we demonstrated that mitochondrial copy number was not a significant marker for predicting prognosis in resectable pancreatic cancer.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cf173ad8f5e0275522fced96387ffc0eTest
https://doi.org/10.1016/j.pan.2018.11.009Test

المؤلفون: Alexander V. Kirichenko, Donald Atkinson, Harry Williams, Suzanne Morrissey, Abhijit Kulkarni, Shailendra Singh, Manav Sharma, Ghita Moussiade, Aslam Syed, Shyam Thakkar, Marcia Mitre, Bharat Rao, Mrinal Garg, Abhishek Gulati, Manish Dhawan, Amy Tang, Suzanne Schiffman, Anthony Lupetin, Dulabh Monga

المصدر: Pancreas. 48:80-84

مصطلحات موضوعية: Male, Resectable Pancreatic Cancer, medicine.medical_specialty, Pancreatic ductal adenocarcinoma, Consensus Development Conferences as Topic, Endocrinology, Diabetes and Metabolism, Stage ii, 03 medical and health sciences, Pancreatectomy, 0302 clinical medicine, Endocrinology, Pancreatic cancer, Outcome Assessment, Health Care, Internal Medicine, Carcinoma, medicine, Humans, Prospective Studies, Stage (cooking), Prospective cohort study, Aged, Hepatology, Tumor size, business.industry, Middle Aged, Prognosis, medicine.disease, Pancreatic Neoplasms, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, Radiology, business, Carcinoma, Pancreatic Ductal

الوصف: Objectives Surgery is the curative treatment for pancreatic ductal adenocarcinoma (PDA). Guidelines recommend utilizing a multidisciplinary pancreatic cancer conference (MDPC) in treatment; however, data are limited. The objective of this study was to assess the accuracy of an MDPC. Methods Patients with PDA presented at an MDPC were prospectively collected from April 2013 to August 2016. Patients were included if the MDPC predicted them to have resectable PDA and underwent upfront surgery. Secondary aims were to compare differences in tumor characteristics, time to surgery, and resection rates with patients prior to MDPC implementation (pre-MDPC). Results A total of 278 patients were presented at the MDPC. After excluding borderline and nonresectable cases, 91 patients were predicted as resectable on evaluation, and 70 were fit for surgery. The MDPC predicted resection in 91.4%. The MDPC had larger tumor size (32.6 vs 24.0 mm), greater proportion of stage II tumor, and a shorter time from diagnosis to resection (27.3 vs 35.5 days) compared with the pre-MDPC. Microscopically negative resections were similar between MDPC and pre-MDPC (85.9% vs 88.0%) despite advanced tumor size and stage. Conclusions The MDPC demonstrates a high resection rate. Compared with a pre-MDPC, MDPC provides shorter time to surgery and selects for advanced tumors.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d6c2061c98545947b138ea6895253a1cTest
https://doi.org/10.1097/mpa.0000000000001209Test

المؤلفون: Versteijne, Eva, van Eijck, Casper, Punt, Cornelis, Suker, Mustafa, Zwinderman, Aeilko, Dohmen, Miriam, Groothuis, Karin, Busch, Oliver, Besselink, Marc, de Hingh, Ignace, ten Tije, Albert, Patijn, Gijs, Bonsing, Bert, de Vos-Geelen, Judith, Klaase, Joost, Festen, Sebastiaan, Boerma, Djamila, Erdmann, Joris, Molenaar, I., van der Harst, Erwin, van der Kolk, Marion, Rasch, Coen, van Tienhoven, Geertjan, for the Dutch Pancreatic Cancer Group (DPCG)

مصطلحات موضوعية: (Borderline) resectable pancreatic cancer, Preoperative radiochemotherapy, Explorative laparotomy, Overall survival, Intention to treat

الوصف: Background Pancreatic cancer is the fourth largest cause of cancer death in the United States and Europe with over 100,000 deaths per year in Europe alone. The overall 5-year survival ranges from 2–7 % and has hardly improved over the last two decades. Approximately 15 % of all patients have resectable disease at diagnosis, and of those, only a subgroup has a resectable tumour at surgical exploration. Data from cohort studies have suggested that outcome can be improved by preoperative radiochemotherapy, but data from well-designed randomized studies are lacking. Our PREOPANC phase III trial aims to test the hypothesis that median overall survival of patients with resectable or borderline resectable pancreatic cancer can be improved with preoperative radiochemotherapy. Methods/design The PREOPANC trial is a randomized, controlled, multicentric superiority trial, initiated by the Dutch Pancreatic Cancer Group. Patients with (borderline) resectable pancreatic cancer are randomized to A: direct explorative laparotomy or B: after negative diagnostic laparoscopy, preoperative radiochemotherapy, followed by explorative laparotomy. A hypofractionated radiation scheme of 15 fractions of 2.4 gray (Gy) is combined with a course of gemcitabine, 1,000 mg/m 2 /dose on days 1, 8 and 15, preceded and followed by a modified course of gemcitabine. The target volumes of radiation are delineated on a 4D CT scan, where at least 95 % of the prescribed dose of 36 Gy in 15 fractions should cover 98 % of the planning target volume. Standard adjuvant chemotherapy is administered in both treatment arms after resection (six cycles in arm A and four in arm B). In total, 244 patients will be randomized in 17 hospitals in the Netherlands. The .

العلاقة: http://www.trialsjournal.com/content/17/1/127Test

الإتاحة: http://www.trialsjournal.com/content/17/1/127Test