Background: Extended pancreatectomy (EP) is the only potential cure for patients with borderline resectable and locally advanced pancreatic cancer.Methods: In the period 2011-2018, 618 resections were performed in patients with pancreatic adenocarcinoma. Standard resections were performed in 476 (77%) patients. EP was performed in 142 (23%) patients. Extended pancreaticoduodenectomy was performed in 79 (55.6%), extended distal resections in 52 (36.6%), extended total pancreatectomy in 11 (7.8%). EP with arterial resections was performed in 14 (2.3%) patients, with venous resections in 91 (14.7%) patients.Results: One or more postoperative complications occurred in 182 patients (38.2%) in the standard resection group and in 63 (44.3%) in the EP group. Mortality was 13.2% (15 patients): 6 (4.2%) patients died after EP and 9 (1.9%) after standard pancreatectomy. Median survival and 5-year overall survival rates were reduced in patients having EP compared with those undergoing a standard resection (15 months, 18% and 25 months, 33%, respectively; c 2 ¼ 2.83, P¼ 0.09, c 2 ¼ 0.16, P¼0.69).Conclusions: These results suggest that morbidity and mortality after EP are comparable with standard pancreatectomy. However, long term results of EP are worse compared with standard pancreatectomy. Extended resections are possible and can increase the number of radically operated patients.

No abstract

Conclusions: Interrogative BiologyÒ platform analytics was employed to infer causal relationships between existing pancreatic cancer therapies and longitudinal alterations in the proteomic, metabolomic, and lipidomic responses to 253 treatment interventions and 211 progression events. We believe this cohort to be the largest high-fidelity pan-omic characterization of pancreatic cancer and its risk factors..

No abstract

5-FU AUC < 27 mcg*h/ml (HR for disease progression 0.321; 95% CI ¼ 0.110-0.940; p ¼ 0.038, HR for death 0.405; 95% CI ¼ 0.184 e 0.997; p ¼ 0.049), in a model controlled by age, sex, resectability and irinotecan dose intensity. There were no differences in G3-4 IPCT-related toxicities according to 5-FU AUC cut-off.Conclusions: 5-FU dose optimization to reach an AUC target of 27 mcg*h/ml by means of pharmacokinetic parameters seems to correlate with longer PFS and OS in this setting.Legal entity responsible for the study: The authors.