Cancer of the pancreas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Ducreux, Michel; Cuhna, Antonio Sa; Caramella, Caroline; Hollebecque, Antoine; Burtin, Pascal; Goèré, Diane; Seufferlein, Thomas; Haustermans, Karin; Laethem, Jean Luc Van; Conroy, Thierry; Arnold, Dirk

doi:10.1093/annonc/mdv295

Cited by 1,138 publications

(1,259 citation statements)

References 54 publications

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“…A preoperative serum CA 19-9 after surgery. 7 In this case, CA 19-9 level was 290.05 UI/mL. Alfa feto protein was also increased to a level of more than 2000.00 ng/mL (normal: < 5 ng/mL).…”

Section: Discussionmentioning

confidence: 64%

“…Common presenting symptoms of pancreatic cancers include jaundice, pain, weight loss, and steatorrhoea. 7 The majority of patients with pancreatic cancer progress to either metastatic or locally advanced disease strategy requires a specialized multidisciplinary team that includes surgeons, medical oncologists, gastroentero-hepatologist, radiologists, and supportive and palliative care specialists. 7 In this case, the pancreatic head cancer presented as a non resectable tumor with metastases, therefore positioning this cancer in an advanced stage.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Palliative Surgery for Biliary Drainage in an Unresectable Pancreatic Cancer

Ys¹,

Rey²,

Andrie³

et al. 2015

InaJGHE

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“…A preoperative serum CA 19-9 after surgery. 7 In this case, CA 19-9 level was 290.05 UI/mL. Alfa feto protein was also increased to a level of more than 2000.00 ng/mL (normal: < 5 ng/mL).…”

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Palliative Surgery for Biliary Drainage in an Unresectable Pancreatic Cancer

Ys¹,

Rey²,

Andrie³

et al. 2015

InaJGHE

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show abstract

“…Surgical margins resected with PD consisted of the pancreatic transection margin, bile duct cut margin, enteric margin, anterior surface, posterior margin, hepatoduodenal ligament margin, and the MUP 17,18,25 . In these margins, The MUP subclassification standards were set according to the definition of margins in the NCCN guidelines 18 because they closely coincide with the "mesopancreas" anatomically 5 8,19 .…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Color Coding Resected Samples from a Pancreaticoduodenectomy with Tissue Marking Dyes for a Detailed Examination of Surgical Margin Surrounding the Uncinate Process of the Pancreas

et al. 2017

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Background: Characteristics of a cancer-positive margin around a resected uncinate process of the pancreas (MUP) due to a pancreticoduodenectomy are difficult to understand by standardized evaluation because of its complex anatomy.The purposes of this study were to subclassify the MUP with tissue marking dyes of different colors and to identify the characteristics of sites that showed positivity for cancer cells in patients with pancreatic head carcinoma who underwent circumferential superior mesenteric arterial nerve plexuspreserving pancreaticoduodenectomy. Results of this evaluation were used to review operation procedures and perioperative methods. Method:We divided the MUP into 4 sections and stained each section with a different color. These sections were the pancreatic head nerve plexus margin (Area A), portal vein groove margin (Area B), superior mesenteric artery margin (Area C), and left of the superior mesenteric artery margin (Area D). The subjects evaluated were 45 patients who had carcinoma of the pancreatic head and were treated with circumferential superior mesenteric arterial nerve plexus-preserving pancreaticoduodenectomy. Results

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“…Therefore, the National Comprehensive Cancer Network, American Society of Clinical Oncology (ASCO) and European Society for Medical Oncology (ESMO) guidelines recommend FOLFIRINOX for metastatic pancreatic adenocarcinoma (MPA) patients with either 0 or 1 ECOG PS and a favorable comorbidity profile. [15][16][17][18][19][20] All guidelines state the mandatory assessment of patients in terms of their condition and comorbidities in order to offer appropriate treatment with a safe toxicity profile. Despite this, the FOLFIRINOX regimen exhibits a specific profile of toxicity among distinct populations.…”

Section: Real-world Viewmentioning

confidence: 99%

Current status on the place of FOLFIRINOX in metastatic pancreatic cancer and future directions

Lambert

Gavoille

Conroy

2017

Therap Adv Gastroenterol

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Pancreatic cancer (PC) incidence rates are rapidly increasing in developed countries, with half the patients being metastatic at diagnosis. For decades, fluorouracil, then gemcitabine regimens were the preferred palliative first-line options for fit patients with metastatic PC. FOLFIRINOX (a combination of bolus and infusional fluorouracil, leucovorin, irinotecan and oxaliplatin) was introduced to clinical practice in 2010 due to the results of the phase II/III trial (PRODIGE 4/ACCORD 11) comparing FOLFIRINOX with singleagent gemcitabine as first-line treatment for patients with MPC. Median overall survival, progression-free survival, and objective response rate were superior with FOLFIRINOX over gemcitabine and there was prolonged time to definitive deterioration in quality of life. Although FOLFIRINOX was also associated with increased toxicity, mainly febrile neutropenia and diarrhea, there has been rapid uptake of this regimen. This review closely examines optimal management and prevention of toxicities, international recommendations for firstline treatment, and use of modified FOLFIRINOX protocols. In this review, we also look at the potential benefit of FOLFIRINOX in selected groups of patients: second-line therapy, adjuvant chemotherapy, induction therapy in patients with borderline resectable and locally advanced PC. Robust validation of the FOLFIRINOX regimen in these settings requires confirmation in further randomized trials.

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Cancer of the pancreas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Cited by 1,138 publications

References 54 publications

Palliative Surgery for Biliary Drainage in an Unresectable Pancreatic Cancer

Palliative Surgery for Biliary Drainage in an Unresectable Pancreatic Cancer

Usefulness of Color Coding Resected Samples from a Pancreaticoduodenectomy with Tissue Marking Dyes for a Detailed Examination of Surgical Margin Surrounding the Uncinate Process of the Pancreas

Current status on the place of FOLFIRINOX in metastatic pancreatic cancer and future directions

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