Efficacy of Neoadjuvant Chemotherapy in Distal Pancreatectomy with En Bloc Celiac Axis Resection (DP-CAR) for Locally Advanced Pancreatic Cancer
This study retrospectively reviewed 20 consecutive patients who underwent DP-CAR at a single institution.ResultsEleven of 20 patients (55.0%) received NAC. Their first regimens were gemcitabine (GEM) plus nab-PTX (n = 7, 63.6%), GEM plus S-1 (n = 3, 27.3%), and GEM (n = 1, 9.1%). Although two patients converted to a second regimen, none abandoned NAC due to adverse effects or could not undergo a planned procedure for disease progression. There were no significant differences in intraoperative variables, morbidity, including pancreatic fistula and delayed gas tric emptying, and mortality between patients with and without NAC; however, patients with NAC had a significantly lower proportion of arterial invasion (p = 0.025), lymphatic invasion (p
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In this study, we assessed the prognostic efficacy and feasibility of combined arterial resection (AR) for locally advanced pancreatic cancer (LAPC), and aimed to identify significant prognostic factors for patients who underwent combined AR.MethodsBetween 1981 and 2018, 733 consecutive patients who underwent pancreatic surgery for PC were identified. The 730 cases with detailed information were enrolled in the analysis.ResultsAmong 730 resected PC patients, 44 (6%) underwent AR including 21 hepatic (48%), 12 celiac (27%), five splenic (12%), four superior mesenteric (9%), and two other arteries (4%). The combined AR surge...
125I radiation downregulates TRPV1 expression through miR‑1246 in neuroblastoma cells. Oncol Rep. 2019 Apr 22;: Authors: Zhang D, Xu H, Wang Y, Wang K, Wang Y, Wu B, Zhu J, Peng L, Gao J, Li Z Abstract Iodine‑125 (125I) seed radiation applied around the celiac ganglion can relieve the refractory pain in pancreatic cancer. In an in vitro cell radiation model of human neuroblastoma cell lines, the impact of 125I radiation on the expression of transient receptor potential vanilloid‑1 (TRPV1) was investigated. The results indicated that the radiation delivering doses 3.12 Gy significantly reduced cel...
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
Condition: Chronic Pain Interventions: Procedure: radiofrequency splanchnic denervation; Procedure: retrocrural celiac denervation Sponsor: Assiut University Not yet recruiting
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]
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.
This article proposes a standardized approach to DP-CAR, including routine neoadjuvant (FOLFIRINOX) chemotherapy. This approach to selecting patients and performing DP-CAR has the potential to improve short-term outcomes and overall surviv al in selected patients, but it should be reserved for high-volume centers.