Is distal pancreatectomy with en-bloc celiac axis resection effective for patients with locally advanced pancreatic ductal adenocarcinoma? -Multicenter surgical group study

We retrospectively investigated the operative outcomes of patients who underwent distal pancreatectomy (DP) for invasive pancreatic ductal adenocarcinoma (PDAC) located at the body and tail.
Source: Pancreatology - Category: Gastroenterology Authors: Source Type: research

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AbstractBackgroundWe analyzed the clinical impact of chemotherapy or chemoradiotherapy as initial treatment (IT), focusing on treatment duration, on morbidity and mortality in patients with resected pancreatic ductal adenocarcinoma.MethodsWe enrolled 509 consecutive patients, with 417 in the upfront surgery group and 92 in the IT group. The IT group was subdivided into 72 patients treated for
Source: Journal of Hepato-Biliary-Pancreatic Sciences - Category: Gastroenterology Authors: Tags: Original Article Source Type: research
CONCLUSIONS: When performed for selected patients at high-volume centers, DP-CAR is associated with acceptable 90-day mortality and overall survival. The authors propose a 90-day mortality risk score to improve patient selection and outcomes, with DP-CAR volume as the dominant predictor. PMID: 30610560 [PubMed - as supplied by publisher]
Source: Ann Oncol - Category: Cancer & Oncology Authors: Tags: Ann Surg Oncol Source Type: research
ConclusionsWhen performed for selected patients at high-volume centers, DP-CAR is associated with acceptable 90-day mortality and overall survival. The authors propose a 90-day mortality risk score to improve patient selection and outcomes, with DP-CAR volume as the dominant predictor.
Source: Annals of Surgical Oncology - Category: Cancer & Oncology Source Type: research
GF Abstract The majority of patients with ductal pancreatic adenocarcinoma are already in a locally advanced or metastatic stage at the time of diagnosis and require palliative therapy. Interventional and operative measures are available for the restoration of biliary outflow in bile duct obstruction and the continuity of the upper intestinal lumen in duodenal or gastric outlet obstruction. In the presence of tumor-related pain, pain therapy according to the World Health Organization (WHO) scheme or a truncus coeliacus blockade, in cachexia a nutritional therapy and in thromboembolic events an anti...
Source: Der Chirurg - Category: Surgery Authors: Tags: Chirurg Source Type: research
Abstract: Pancreatic adenocarcinoma has a very poor prognosis. Complete surgical resection remains the only current curative treatment. Locally advanced pancreatic cancers are considered as unresectable because of involvement of celiac and/or mesenteric vessels. Irreversible electroporation has recently been introduced to induce permanent cell death by apoptosis. Irreversible electroporation is a nonthermal cell-destruction technique that was claimed to allow destruction of cancerous cells with less damage to surrounding supporting connective tissues with collagenic structure (such as nearby blood vessels, biliary ducts, a...
Source: Pancreas - Category: Gastroenterology Tags: Review Source Type: research
Recently, InsideSurgery had a chance to speak with Dr. Charles J. Yeo about his career as a top Whipple and pancreas surgeon and his ongoing role as a surgical leader and educator. As the Samuel D. Gross Professor of Surgery and Chair of the Department of Surgery, you welcomed your second intern class to Thomas Jefferson University in Philadelphia, Pennsylvania last month. What one piece advice do you have for your new trainees? One piece of advice….that’s tough! Several pieces of advice….enjoy the challenges and experiences of internship; read and increase your k...
Source: Inside Surgery - Category: Surgery Authors: Tags: Interviews Source Type: blogs
Gastric metastasis from pancreatic cancer is very rare. There is a few report on surgery for gastric metastasis from pancreatic cancer. So we report a case of gastric metastasis from pancreatic body cancer after distal pancreatectomy with celiac axis resection (DP-CAR). A 68-year-old man underwent DP-CAR for pancreatic body cancer in June 2009. The histological diagnosis was well-differentiated adenocarcinoma of pancreas, stage IVa; T4N1M0. He was enforced chemotherapy with Gemcitabine for 1 year, then with S-1 for 1 year after surgery.
Source: Pancreatology - Category: Gastroenterology Authors: Source Type: research
Authors: Dusunceli Atman E, Erden A, Ustuner E, Uzun C, Bektas M Abstract This pictorial review aims to illustrate the magnetic resonance imaging (MRI) findings and presentation patterns of anatomical variations and various benign and malignant pathologies of the duodenum, including sphincter contraction, major papilla variation, prominent papilla, diverticulum, annular pancreas, duplication cysts, choledochocele, duodenal wall thickening secondary to acute pancreatitis, postbulbar stenosis, celiac disease, fistula, choledochoduodenostomy, external compression, polyps, Peutz-Jeghers syndrome, ampullary carcinoma an...
Source: Korean Journal of Radiology - Category: Radiology Tags: Korean J Radiol Source Type: research
Authors: Tsuchikawa T, Hirano S, Nakamura T, Okamura K, Tamoto E, Shichinohe T Abstract Increasing evidence has contraindicated extended radical dissection of pancreatic adenocarcinoma (PC). With the recent improvement of perioperative management techniques and multimodal treatment strategy for PC, concomitant major vessel resection and reconstruction has thus been aggressively attempted in association with comparatively better pathologically negative surgical margins and postoperative survival. We have discussed the clinical relevance of concomitant major vessel resection mainly focusing on indications for such re...
Source: Postgraduate Medicine - Category: Internal Medicine Tags: Postgrad Med Source Type: research
Abstract BACKGROUND AND PURPOSE: Histopathological findings of patients who underwent resection for pancreatic adenocarcinoma (PC) after preoperative chemoradiotherapy (CRT) reportedly showed beneficial effects. The purpose of our study was to evaluate the correlation between histopathological effects (HE) of preoperative CRT and treatment parameters [radiation and gemcitabine (GEM) doses]. MATERIAL AND METHODS: HE of CRT were assessed on 158 primary lesions of 157 patients with PC who underwent pancreatic resection after preoperative CRT with GEM between January 2006 and December 2011. The radiation dose del...
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - Category: Radiology Authors: Tags: Radiother Oncol Source Type: research
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