Does anyone survive pancreatic ductal adenocarcinoma? A nationwide study re-evaluating the data of the Finnish Cancer Registry

Carpelan-Holmström, Monika; Nordling, Stig; Pukkala, Eero; Sankila, Risto; Lüttges, Jutta; Klöppel, Günter; Haglund, Caj

doi:10.1136/gut.2004.047191

Cited by 283 publications

(191 citation statements)

References 34 publications

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“…1 Fatality is because of the lack of effective screening strategies, inconspicuous early symptoms and poor response to existing therapies leading to a median survival of B1 year. 2 New forms of treatment for this disease are urgently needed, and this has led to research on the use of human viruses as therapeutic gene delivery systems for the treatment of pancreatic cancers. 3 Human adenoviruses (Ad), especially those of species C such as Ad5, have considerable potential as gene therapy vectors due to many favorable features, for example, their ability to grow to high titers in complementing cell lines, such as 293 cells, and their efficient transduction of a wide variety of target tissues.…”

Section: Introductionmentioning

confidence: 99%

The roles of cell surface attachment molecules and coagulation Factor X in adenovirus 5-mediated gene transfer in pancreatic cancer cells

et al. 2011

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Transduction of 11 pancreatic cancer cell lines with a replication-deficient adenovirus 5 expressing enhanced green fluorescent protein (Ad5EGFP) was analyzed and variable EGFP levels were observed, ranging from o1% to B40% of cells transduced, depending on the cell line. Efficient Ad5EGFP transduction was associated mainly with higher levels of cell surface Coxsackie and adenovirus receptor (CAR) but not with expression of a v b 3 and a v b 5 integrins and was fiber dependent. Reduction of CAR by RNA interference resulted in a corresponding decrease in Ad5EGFP transduction. Pre-treatment of Ad5EGFP with blood coagulation Factor X increased virus entry even in the presence of low CAR levels generated by RNA interference, suggesting a potential alternative route of Ad5 entry into pancreatic cancer cells. Immunohistochemistry carried out on 188 pancreatic ductal adenocarcinomas and 68 matched controls showed that CAR was absent in 102 (54%) of adenocarcinomas, whereas moderate and strong staining was observed in 58 (31%) and 28 (15%) cases, respectively. Weak or absent CAR immunolabeling correlated with poor histological differentiation of pancreatic cancer. In normal tissue, strong immunolabeling was detected in islet cells and in the majority of inter-and intralobular pancreatic ducts.

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Section: Introductionmentioning

confidence: 99%

The roles of cell surface attachment molecules and coagulation Factor X in adenovirus 5-mediated gene transfer in pancreatic cancer cells

et al. 2011

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“…The tumor is extremely aggressive and early detection is difficult due to the lack of early disease-specific signs and symptoms. Only 10-20% of patients with pancreatic cancer are candidates for curative resection (1,2) and, even if surgery is performed, the post-operative 5-year survival rate is only 15-25% due to the high incidence of postoperative recurrence (1,3,4). Gemcitabine (difluorodeoxycitidine, dFdC; GEM) is the standard treatment for advanced/metastatic pancreatic cancer based on a landmark trial comparing its effects with those of fluorouracil (FU) (5).…”

Section: Introductionmentioning

confidence: 99%

Predicting the chemosensitivity of pancreatic cancer cells by quantifying the expression levels of genes associated with the metabolism of gemcitabine and 5-fluorouracil

et al. 2011

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Abstract. Gemcitabine (GEM) is the standard treatment for advanced/metastatic pancreatic cancer. However, there is a substantial subset of patients in whom the efficacy of GEM, when used as a single agent, is inadequate. Recently, the 5-fluorouracil (5-FU) prodrugs capecitabine and S-1 have been used as an alternative, either alone or in combination with GEM. The aim of the present study was to investigate the expression pattern of genes that render pancreatic cancer cells sensitive to GEM and 5-FU, and to identify markers for individualized chemotherapy, even in patients who have developed resistance. We investigated the correlation between the expression of genes associated with the metabolism of GEM and 5-FU, and sensitivity to these drugs in 15 human pancreatic cancer cell lines. We also established GEM-and 5-FU-resistant pancreatic cancer cell lines to investigate changes in the expression levels of these genes and the effects of one drug on cells resistant to the other. We found no correlation between pancreatic cancer cell sensitivity to either GEM-or 5-FU. GEM-resistant cells did not become resistant to 5-FU and vice versa. High expression of RRM1 (P=0.048) and TS x DPD (P= 0.035) correlated significantly with sensitivity to GEM and 5-FU, respectively. 5-FU-resistant cells expressed significantly higher levels of TP than parental cells (P<0.05). In conclusion, pancreatic cancer cells showed no crossresistance to GEM and 5-FU. Quantitative analyses of RRM1, TP, DPD and TS mRNA levels in pancreatic cancer cells may be useful for predicting their sensitivity to GEM and 5-FU.

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“…[1][2][3] Surgical resection offers significantly improved prognosis with a median survival 14-20 months and 5 year survival rates less than 7-10% Table 1. 1,4,5 Current scenario in such a tricky situation is a difficult proposition as outcome with other alternative therapies are not acceptable in terms of survival and quality of life. [6][7][8] Some recent reports show improved survival with Gemcitabine as a first line of therapy.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Surgical resection offers significantly improved prognosis with a median survival 14-20 months and 5 year survival rates 8%. 4,5 When surgical resection was compared with radio chemotherapy for resectable pancreatic cancer, patients in operative group done fairly well with median survival of 17 months versus 11 months in chemoradiation group. 6,7 Few studies report improvements especially with regard to quality of life, are primarily due to use of gemcitabine as first line chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Audit of 62 cases of pancreatic resections for pancreatic cancer

Nichkaode¹,

Bhukte²,

Bandhe³

2017

Int Surg J

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Background: Varieties of pancreatic pathologies, needs resection of pancreatic tissue. Adenocarcinoma of the pancreatic duct is the most common malignancy presenting with early metastasis and seen as resistant to alternative treatment regimens currently available. Management and handling of such tumors is a complex and challenging task for a surgeon. Surgical resection offers an improved prognosis, with a median survival after resection of 14-20 months and up to 25% 5-year survival rates. Present study is aimed at presenting data of 62 pancreatic resections for various malignant pancreatic lesions.Methods: This is an ongoing longitudinal study which started in 2009 at teaching institute in central India. Though we had 109 patients for pancreatic resection, only 62 patients were considered suitable for the study. All patients after admission were thoroughly investigated and then considered for surgery. 48 patients were male and 14 patients were female. Age group was ranging from 33 to 65 years with mean age between 45 to 55 years. Spectrum of various malignancies and different types of pancreatic resections were done and results are presented here.Results: Pancreatic adenocarcinoma is an aggressive malignancy responds to surgical treatment better than other alternative modalities. In the present series out of 62 patients 27 patients with pancreatic head cancer, 22 patients with periampullary cancer, 2 patients with duodenal cancer, 6 patients with distal cholangio carcinoma, 1 patient with mucinous cystadenocarcinoma. 4 patients with body and tail of pancreas cancer. Average age 38 to 65 years, 47 males and 15 females. Commonest procedure was Whipple’s operation, and distal pancreatectomy. Survival in present series was 18 -24 months and 5-year survival was 12 % that is seen mainly with Periampullary cancer.Conclusions: Surgery is the only chance of cure or long-term survival in pancreatic cancer. Chemo radiation as a primary therapy is ineffective. But some reports suggest the improved quality of life with palliative chemotherapy. Biology of the disease is the king and dictates the survival, the type of surgical procedure had no impact on survival, nor on morbidity and mortality.

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Does anyone survive pancreatic ductal adenocarcinoma? A nationwide study re-evaluating the data of the Finnish Cancer Registry

Cited by 283 publications

References 34 publications

The roles of cell surface attachment molecules and coagulation Factor X in adenovirus 5-mediated gene transfer in pancreatic cancer cells

The roles of cell surface attachment molecules and coagulation Factor X in adenovirus 5-mediated gene transfer in pancreatic cancer cells

Predicting the chemosensitivity of pancreatic cancer cells by quantifying the expression levels of genes associated with the metabolism of gemcitabine and 5-fluorouracil

Audit of 62 cases of pancreatic resections for pancreatic cancer

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