A Quantitative Clinicopathological Signature for Predicting Recurrence Risk of Pancreatic Ductal Adenocarcinoma After Radical Resection

Recurrence and distant metastases were main reasons of unfavorable outcomes for patients with pancreatic ductal adenocarcinoma (PDAC) after surgery. The aim of this study was to describe the patterns, timing, and predictors of recurrence or metastasis in PDAC patients after curative surgery. Patients with PDAC who underwent radical pancreatectomy were included. Associations between clinicopathological and radiological characteristics and specific pattern of progression were investigated. Least absolute shrinkage and selection operator (LASSO) and Cox regression were applied to assess the prognostic factors for overall survival (OS) and progression-free survival (PFS). A total of 302 patients were included into present study, and 173 patients were documented as recurrence after a median survival of 24.7 months. More than half of patients recurred after 12 months after surgery, and the liver was the most common metastatic site. Decreased time interval to progression, elevated carbohydrate antigen 19-9 (CA19-9) level, and lymph node (LN)16 metastasis were independent predictors for reduced OS. Independent prognostic factors for PFS included elevated carcinoembryonic antigen (CEA) level, local progression, liver or lung-only metastasis, local + distant progression, multiple metastases, LN16 metastasis, imaging tumor size, chemotherapy, and tumor–node–metastasis (TNM) stage. The predictive system showed valuable prediction performance with values of concordance indexes...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research

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In conclusion, the nomogram based on inflammatory biomarkers can serve as useful prognostic tool for advanced PDAC. In addition, patients with high NTP can greater benefit from combination chemotherapy than monotherapy.
Source: Journal of Cancer - Category: Cancer & Oncology Authors: Tags: Research Paper Source Type: research
ConclusionOur findings suggest that the clinical effects of preoperative CRT would be favorable in PDAC patients with renal impairment.
Source: Cancer Chemotherapy and Pharmacology - Category: Cancer & Oncology Source Type: research
Conclusion.A significant subset of patients with mPDAC can achieve long‐term survival (≥18 months) in 2018. We identified low NLR as a significant prognostic factor associated with long‐term survival in mPDAC.Implications for Practice.Metastatic pancreatic ductal adenocarcinoma (mPDAC) is one of the most lethal types of cancer. A subset of patients with mPDAC can achieve long‐term survival (≥18 months) with a modern chemotherapy regimen, such as FOLFIRINOX or gemcitabine/nab‐paclitaxel. We identified low neutrophil‐to‐lymphocyte ratio (NLR) as a significant prognostic factor associated with long‐term su...
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Gastrointestinal Cancer Source Type: research
CONCLUSION: The 'triangle operation' for borderline resectable pancreatic head cancer can be achieved safely by laparoscopy in carefully selected patients.1-11 Proven experience in both open and laparoscopic pancreatic surgery is mandatory. PMID: 31802299 [PubMed - as supplied by publisher]
Source: Ann Oncol - Category: Cancer & Oncology Authors: Tags: Ann Surg Oncol Source Type: research
ConclusionThe ‘triangle operation’ forborderline resectable pancreatic head cancer can be achieved safely by laparoscopy in carefully selected patients.1–11 Proven experience in both open and laparoscopic pancreatic surgery is mandatory.
Source: Annals of Surgical Oncology - Category: Cancer & Oncology Source Type: research
ConclusionsUnexpected para-aortic lymph node metastasis on frozen section biopsy may no longer be a contraindication to curative resection in “resectable” pancreatic ductal adenocarcinoma, as long as postoperative adjuvant chemotherapy can be administered.
Source: Journal of Gastrointestinal Surgery - Category: Surgery Source Type: research
Publication date: Available online 28 November 2019Source: Acta Pharmaceutica Sinica BAuthor(s): Yu Zhou, Wenxi Zhou, Xinli Chen, Qingbing Wang, Chao Li, Qinjun Chen, Yu Zhang, Yifei Lu, Xiaoyi Ding, Chen JiangAbstractPancreatic ductal adenocarcinoma (PDAC) is one of the most intractable malignancy, with an only 6% 5-year relative survival rate. The dismal therapeutic effect is attributed to the chemotherapy resistance and unique pathophysiology with abundant inflammatory cytokines and abnormal hyperplasia of extracellular matrix (ECM). Based on the theory that bone marrow mesenchymal stem cells (BM-MSCs) can influence the...
Source: Acta Pharmaceutica Sinica B - Category: Cancer & Oncology Source Type: research
AbstractThe Japanese guideline for gastroenteropancreatic neuroendocrine tumor treatment recommends everolimus or sunitinib as first-line treatment for unresectable pancreatic neuroendocrine tumors (PNETs). Streptozocin (STZ) is recommended as an alternative. We encountered a patient with PNET who had multiple liver metastases and who showed a remarkable response to third-line STZ. The patient was a 50-year-old man with a pancreatic head tumor 32  mm in diameter. We planned to perform subtotal stomach-preserving pancreaticoduodenectomy, but abandoned resecting the pancreas during the surgery upon discovering a small l...
Source: International Cancer Conference Journal - Category: Cancer & Oncology Source Type: research
Wang Rong Hu Resistance to chemotherapy is a major clinical challenge in the treatment of pancreatic ductal adenocarcinoma (PDAC). Here, we provide evidence that Rho associated coiled-coil containing protein kinase 2 (ROCK2) maintains gemcitabine resistance in gemcitabine resistant pancreatic cancer cells (GR cells). Pharmacological inhibition or gene silencing of ROCK2 markedly sensitized GR cells to gemcitabine by suppressing the expression of zinc-finger-enhancer binding protein 1 (ZEB1). Mechanically, ROCK2-induced sp1 phosphorylation at Thr-453 enhanced the ability of sp1 binding to ZEB1 promoter regions in a p...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Article Source Type: research
A new radiomics technique can determine which lung cancer patients will benefit...Read more on AuntMinnie.comRelated Reading: AI, radiomics predict prostate cancer aggressiveness CT radiomics uses immunohistology to detect thyroid cancer AI can improve reproducibility of radiomics in CT Can radiomics detect pancreatic ductal adenocarcinoma? AI, radiomics can help predict chemotherapy response
Source: AuntMinnie.com Headlines - Category: Radiology Source Type: news
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