Evaluation of the MDACC clinical classification system for pancreatic cancer patients in an European multicenter cohort

This study intents to evaluate the proposed borderline classification system in a multicenter patient cohort without neoadjuvant treatment.MethodsEvaluation was based on a multicenter database of pancreatic cancer patients undergoing surgery from 2005 to 2016 (n = 1020). Complications were classified based on the Clavien-Dindo classification. χ2-test, Kaplan–Meier estimator and Cox regression hazard model were used for statistical analysis.ResultsMost patients (55.1%) were assigned as type A patients, followed by type C (35.8%) and type B patients (9.1%). Neither the complication rate, nor the mortality rate revealed a correlation to any subgroup. Type B patients had a significant worse progression free (p 
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research

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CONCLUSIONS: NeoTx is not only cytotoxic, but has pleiotropic, beneficial effects on all cellular and non-cellular components of PCa. Combinational approaches including immunotherapy may unleash long-term and more effective anti-tumor responses and improve prognosis of PCa. PMID: 31585935 [PubMed - as supplied by publisher]
Source: Clinical Cancer Research - Category: Cancer & Oncology Authors: Tags: Clin Cancer Res Source Type: research
Publication date: Available online 30 August 2019Source: Seminars in Ultrasound, CT and MRIAuthor(s): Axel Dallongeville, Lucie Corno, Stéphane Silvera, Isabelle Boulay-Coletta, Marc ZinsAbstractComputed Tomography remains the optimal imaging modality for both diagnosis and staging of pancreatic adenocarcinoma. Especially, CT is highly accurate in assessing the relationship of the tumor to critical arterial and venous structures, since their involvement can preclude surgical resection or indicate a neoadjuvant strategy in borderline resectable or locally advanced lesions. MRI provides additional staging information ...
Source: Seminars in Ultrasound, CT and MRI - Category: Radiology Source Type: research
ConclusionDespite neoadjuvant therapy leading to resection and relatively favorable pathologic tumor characteristics in BRPC/LAPC patients, more than 80% of patients experienced disease recurrence, 72.5% of which occurred at distant sites.
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research
Although pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy, incremental progress has been realized over the past decade with new chemotherapeutic regimens, advanced surgical techniques, and an improved understanding of genetics. Although most patients are not candidates for surgical resection because of metastatic disease, many centers are focused on offering curative treatment for patients with borderline resectable (BR) or locally advanced (LA) tumors. These patients are treated with chemotherapy and radiation up front followed by surgical resection, and surgery often includes the resection and reconstr...
Source: JAMA Surgery - Category: Sports Medicine Source Type: research
Conclusions In patients with BRPC who undergo resection after induction treatment, the OS was significantly better than in patients with RPC. Neoadjuvant treatment should be considered for all localized PDACs.
Source: Pancreas - Category: Gastroenterology Tags: Original Articles Source Type: research
Publication date: Available online 19 June 2019Source: Hepatobiliary &Pancreatic Diseases InternationalAuthor(s): Stefan Heinrich
Source: Hepatobiliary and Pancreatic Diseases International - Category: Gastroenterology Source Type: research
Publication date: Available online 23 May 2019Source: Hepatobiliary &Pancreatic Diseases InternationalAuthor(s): June S Peng, Jane Wey, Sricharan Chalikonda, Daniela S Allende, R Matthew Walsh, Gareth Morris-StiffAbstractBackgroundPrevious studies have demonstrated the prognostic significance of pathologic tumor response in pancreatic adenocarcinoma following neoadjuvant therapy (NAT). The aim of this study was to determine the incidence of significant pathologic response to NAT in borderline resectable pancreatic cancer (BRPC), and association of NAT regimen and other clinico-pathologic characteristics with pathologic...
Source: Hepatobiliary and Pancreatic Diseases International - Category: Gastroenterology Source Type: research
SummaryBackgroundPancreatic cancer is the third leading cause of cancer-related death in the Western world and is projected to soon become the second commonest cause of cancer mortality. During the past two decades, there have been important clinical developments in the fight against this aggressive disease.ObjectiveThe aim of this review article is to summarize the evolution of the multidisciplinary oncological and surgical management of pancreatic cancer.ResultsThe centralization of pancreatic surgery into specialized institutions has led to improvements in surgical techniques, with reduced surgical mortality rates of
Source: European Surgery - Category: Surgery Source Type: research
SummaryAlthough some improvements have been made in recent years, the prognosis of pancreatic ductal adenocarcinoma remains poor. Surgical resection followed by adjuvant systemic therapy is the only curative treatment option in early stage disease. The role of radiotherapy in the treatment of pancreatic cancer is not well defined and still controversially discussed. Following the results of the ESPAC-1 trial, adjuvant radiochemotherapy (RCT) was no longer employed in most European countries. Nevertheless, in high-risk situations for local recurrence, the addition of adjuvant radiochemotherapy to adjuvant systemic therapy s...
Source: European Surgery - Category: Surgery Source Type: research
Objective: The aim of this study was to determine (1) whether preoperative factors can predict resectability of borderline resectable (BR) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC) after neoadjuvant FOLFIRINOX, (2) which patients might benefit from adjuvant therapy, and (3) survival differences between resected BR/LA patients who received neoadjuvant FOLFIRINOX and upfront resected patients. Background: Patients with BR/LA PDAC are often treated with FOLFIRINOX to obtain a margin-negative resection, yet selection of patients for resection remains challenging. Methods: Clinicopathologic data ...
Source: Annals of Surgery - Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research
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