Percutaneous Radiofrequency Ablation for Metachronous Hepatic Metastases after Curative Resection of Pancreatic Adenocarcinoma.

Percutaneous Radiofrequency Ablation for Metachronous Hepatic Metastases after Curative Resection of Pancreatic Adenocarcinoma. Korean J Radiol. 2020 Mar;21(3):316-324 Authors: Lee SJ, Kim JH, Kim SY, Won HJ, Shin YM, Kim PN Abstract OBJECTIVE: To retrospectively evaluate the safety and efficacy of percutaneous radiofrequency ablation (RFA) in patients with metachronous hepatic metastases arising from pancreatic adenocarcinoma who had previously received curative surgery. MATERIALS AND METHODS: Between 2002 and 2017, percutaneous RFA was performed on 94 metachronous hepatic metastases (median diameter, 1.5 cm) arising from pancreatic cancer in 60 patients (mean age, 60.5 years). Patients were included if they had fewer than five metastases, a maximum tumor diameter of ≤ 5 cm, and disease confined to the liver or stable extrahepatic disease. For comparisons during the same period, we included 66 patients who received chemotherapy only and met the same eligibility criteria described. RESULTS: Technical success was achieved in all hepatic metastasis without any procedure-related mortality. During follow-up, local tumor progression of treated lesions was observed in 38.3% of the tumors. Overall median survival and 3-year survival rates were 12 months and 0%, respectively from initial RFA, and 14.7 months and 2.1%, respectively from the first diagnosis of liver metastasis. Multivariate analysis showed that a large tumor diameter of> 1.5 cm, a lat...
Source: Korean Journal of Radiology - Category: Radiology Tags: Korean J Radiol Source Type: research

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AbstractBackgroundPancreatic cancer is a  devastating disease with a 5-year survival rate of 20–25%. As approximately only 20% of patients diagnosed with pancreatic cancer are initially staged as resectable, it is necessary to evaluate new therapeutic approaches. Hence, neoadjuvant (radio)chemotherapy is a promising therapeutic option , especially in patients with a borderline resectable tumor. The aim of this non-randomized, monocentric, prospective, phase II clinical study was to assess the prognostic value of functional imaging techniques, i.e., [18F]2-fluoro-2-deoxy-d-glucose positron emi...
Source: Strahlentherapie und Onkologie - Category: Cancer & Oncology Source Type: research
Pancreatic ductal adenocarcinoma (PDAC) is a deadly disease with poor survival rates. For borderline resectable or unresectable disease, intensive multi ‐drug chemotherapy regimens with either modified FOLFIRINOX (mFOLF) or nab‐paclitaxel plus gemcitabine are preferred. We retrospectively compared these two chemotherapy regimens in patients who completed resection and found the mFOLF group had better overall clinical and pathological response ra tes. Randomized clinical trials are needed, and this study provides valuable information in the interim. AbstractWe conducted an institutional study to compare the clinical and...
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH 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
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
AbstractObjectivesTo assess factors associated with radical resection (R0) of pancreatic ductal adenocarcinoma (PDAC) after induction treatment with FOLFIRINOX.MethodsPatients with either locally advanced (LA) and borderline resectable (BR) PDAC undergoing surgical exploration after FOLFIRINOX were retrospectively enrolled. Two pancreatic radiologists reviewed the CT blinded to the final outcome and assessed chemotherapy response and resectability. Patients were then divided into R0 resected (group A) and not resected/R1 resected (group B), which were compared.ResultsOf 59 patients included, 19 were defined as unresectable...
Source: European Radiology - Category: Radiology Source Type: research
Objectives Neoadjuvant treatment (NT) consisting in chemotherapy or radio chemotherapy is efficient in borderline (BL) and locally advanced (LA) pancreatic cancer (PC) , allowing a higher rate of R0 resection. It has been shown that a major response (downstaging to T0 and T1 tumors) is a good prognostic factor , but real outcome of these patients has been poorly described.
Source: Pancreatology - Category: Gastroenterology Authors: Tags: 5. Pancreatic Cancer II Source Type: research
Opinion statementPancreatic adenocarcinoma 2030 (PCa) is predicted to be the second leading cause of cancer death in USA by 2030. To date, attempts at early detection have been unsuccessful. Therapies for resectable PCa include surgery followed by adjuvant chemotherapy with or without radiotherapy. Unfortunately, most patients with PCa present with advanced disease and thus only 20% of patients are potentially resectable upon presentation. Improved surgical techniques along with adjuvant combination chemotherapy have improved outcomes for patients with resectable disease. The optimal treatment approach for borderline resec...
Source: Current Treatment Options in Oncology - Category: Cancer & Oncology Source Type: research
Conclusions: Collectively, our data show that GRP78 expression promotes chemoresistance in PDAC and therapeutic strategies blocking the activity of GRP78 increase the efficacy of currently available therapies.Citation Format: Jenifer B. Gifford, Wei Huang, Ann E. Zeleniak, Antreas Hindoyan, Hong Wu, Timothy R. Donahue, Reginald Hill.{Authors}. ER chaperone GRP78 increases chemoresistance in pancreatic ductal adenocarcinoma. [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Advances in Science and Clinical Care; 2016 May 12-15; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2016;76(24 Suppl):Abstract nr B08.
Source: Cancer Research - Category: Cancer & Oncology Authors: Tags: Molecular Drivers of Pancreatic Cancer Biology and Metastasis Source Type: research
Conclusion: This case series demonstrates complete pathologic remission in patients receiving neoadjuvant treatment for advanced pancreatic cancer. When compared to OS of patients with metastatic or locally advanced disease who do not achieve pCR or undergo resection, pCR seems to be associated with improved OS. The ideal treatment regimen and duration of treatment in order to achieve higher rates of pCR is yet to be investigated.Citation Format: Neda Hashemi-Sadraei, Hai Nguyen, Bert O’Neil, Michael G. House, Safi Shahda.{Authors}. Pathologic complete response following systemic chemotherapy with or without chemorad...
Source: Cancer Research - Category: Cancer & Oncology Authors: Tags: Clinical Investigation Source Type: research
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