Five‐year actual survival after pancreatoduodenectomy for pancreatic head cancer

Perysinakis, Iraklis; Avlonitis, Spyridon; Georgiadou, Despoina; Tsipras, Hercules; Margaris, Ilias

doi:10.1111/ans.12422

Cited by 22 publications

(15 citation statements)

References 28 publications

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“…Pancreatic ductal adenocarcinoma (PDAC) is one of the most dismal malignancies with an overall 5-year survival rate of < 7% [ 1 , 2 ]. Despite enormous efforts directed at the treatment of PDAC, radical resection remains the most effective treatment modality, and it increases the 5-year survival rate for PDAC patients to 10–25% [ 3 – 5 ]. However, due to a lack of presentations at early stages and the aggressive nature of this disease, the majority of PDAC patients present an unresectable disease at the time of diagnosis, and only around 20% of newly diagnosed PDAC patients were suitable candidates for curable surgical resection [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Predictors of distant metastasis on exploration in patients with potentially resectable pancreatic cancer

Liu

Chen

et al. 2018

BMC Gastroenterol

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BackgroundPatients with potentially resectable pancreatic ductal adenocarcinoma (PDAC) are frequently found to be unresectable on exploration due to small distant metastasis. This study was to investigate predictors of small distant metastasis in patients with potentially resectable PDAC.MethodsPatients who underwent surgical exploration for potentially resectable PDAC from 2013 to 2014 were reviewed retrospectively and divided into two groups according to whether distant metastases were encountered on exploration. Then, univariate and multivariate logistic regression analyses were used to identify predictors of distant metastasis. A scoring system to predict distant metastasis of PDAC on exploration was constructed based on the regression coefficient of a multivariate logistic regression model.ResultsA total of 235 patients were included in this study. Mean age of the study population was 61.7 ± 10.4 years old. Upon exploration, distant metastases were found intraoperatively in 62 (26.4%) patients, while the remaining 173 were free of distant metastases. Multivariate logistic regression analysis identified that age ≤ 62 years old (p < 0.001), male sex (p = 0.011), tumor size ≥4.0 cm (p < 0.001), alanine aminotransferase level (ALT) < 125 U/L (p < 0.001), and carbohydrate antigen (CA19–9) level ≥ 385 U/mL (p < 0.001) were independent risk factors for occult distant metastasis of PDAC. A preoperative scoring system (0–8 points) for distant metastasis on exploration was constructed using these five factors. The receiver operating characteristic curves showed that the area under the curve of this score was 0.85. A score of 6 points was suggested to be the optimal cut-off value, and the sensitivity and specificity were 85% and 69%, respectively.ConclusionsDistant metastasis is still frequently encountered on exploration for patients with potentially resectable PDAC. Younger age, male sex, larger tumor size, low ALT level and high CA19–9 level are independent predictors of unexpected distant metastasis on exploration.

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Section: Introductionmentioning

confidence: 99%

Predictors of distant metastasis on exploration in patients with potentially resectable pancreatic cancer

Liu

Chen

et al. 2018

BMC Gastroenterol

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“…fr) shows that approximate 400,000 people died from pancreatic cancer each year, ranking the seventh leading causes of cancer death [1]. The overall five-year survival rate of pancreatic cancer is far below 10% and the lowest of almost all types of cancers [2]. Surgery is considered to be the only potential treatment, followed by adjuvant chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

“…However, pancreatic cancer is not sensitive to most of the current chemotherapeutic drugs [3]. Over 80% of patients with pancreatic cancer are diagnosed when the lesion is not suitable for operation [2]. Therefore, it is urgent to develop an effective drug with less toxic and side effects to treat patients with pancreatic cancer.…”

Section: Introductionmentioning

confidence: 99%

Chemopreventive effect of Betulinic acid via mTOR -Caspases/Bcl2/Bax apoptotic signaling in pancreatic cancer

Guo

Zhu

Wang

et al. 2020

BMC Complement Med Ther

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Background: Pancreatic cancer is aggressive with no symptoms until the advanced stage reached. The increased resistance of pancreatic cancer to chemotherapy demonstrates a dilemma in the clinical field. Hence, it is a matter of great urgency to develop an effective drug to treat patients with pancreatic cancer. Betulinic acid is a major triterpene isolated from spina date seed. Several studies have suggested its low toxicity and side effects to patients with malaria and inflammation. However, relevant studies on betulinic acid in inhibiting cancer were insufficient and the molecular mechanism was unclear. This study aimed to systematically explore the potential anti-cancer functions of betulinic acid in pancreatic cancer, and investigate its underlying molecular mechanism. Methods: The Counting Kit-8 assay, colony formation, transwell invasion assay, wound healing assay, flow cytometry and xenograft nude mice model were used to evaluate the effect of betulinic acid on the proliferation, invasion and migration ability of pancreatic cancer cells. Results: Our results showed that betulinic acid obviously suppressed pancreatic cancer both in vitro and in vivo in a dose-dependent manner. We also determined that betulinic acid inhibited pancreatic cancer by specifically targeting mTOR signaling rather than Nrf2 or JAK2. Conclusions: These findings clarify that betulinic acid is a potential and valuable anticancer agent for pancreatic cancer, and indicate the specific molecular target of betulinic acid.

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“…Surgery is the only curative modality if R0 resection is feasible. Unfortunately, even in that group of patients, the 5-year survival rate is about 14%, with a median survival duration of 24 months 45 . In many institutions, the most common treatment today is either chemotherapy alone or combined with chemoradiation.…”

Section: Discussion and Summarymentioning

confidence: 85%

Role of Neoadjuvant Therapy in the Management of Pancreatic Cancer: Is the Era of Biomarker-Directed Therapy Here?

Цветкова

Asmis

2014

Current Oncology

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Pancreatic cancer is the 4th leading cause of cancerrelated death. Complete surgical resection (CR0) is considered the only curative treatment. Most patients present with unresectable or borderline resectable disease. Many small phase i/ii trials have tried to address the role of neoadjuvant treatment using chemotherapy with or without chemoradiation in the management of locally advanced disease. However, many of them looked at the rate of CR0 resection and the feasibility of such treatment. A trend for improved overall survival has been observed in the group of patients with borderline resectable disease who completed neoadjuvant treatment. A large proportion of patients progress while on treatment, sparing them from unnecessary surgery. We searched the PubMed database (using the key words “pancreatic cancer,” or “pancreatic neoplasm,” or “pancreatic adenocarcinoma,” and “neoadjuvant treatment,” or “neoadjuvant chemotherapy,” or “neoadjuvant radiation therapy,” or “neoadjuvant chemoradiation,” or “adjuvant therapy” [all fields] and “clinical trial” or “study”) and abstracts presented at the American Society of Clinical Oncology meetings on gastrointestinal cancers. Here, we review the most recent papers that present results on neoadjuvant therapy in pancreatic cancer. All but one report used overall survival as an endpoint. Unfortunately, there are no valid biomarkers predicting tumour progression or recurrence, and response to treatment than can help to guide therapeutic choices. Our recommendation is to consider neoadjuvant treatment in cases of borderline resectable disease. In patients with primary resectable tumours, surgery followed by adjuvant treatment and enrollment on adjuvant treatment studies would be appropriate.

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Five‐year actual survival after pancreatoduodenectomy for pancreatic head cancer

Cited by 22 publications

References 28 publications

Predictors of distant metastasis on exploration in patients with potentially resectable pancreatic cancer

Predictors of distant metastasis on exploration in patients with potentially resectable pancreatic cancer

Chemopreventive effect of Betulinic acid via mTOR -Caspases/Bcl2/Bax apoptotic signaling in pancreatic cancer

Role of Neoadjuvant Therapy in the Management of Pancreatic Cancer: Is the Era of Biomarker-Directed Therapy Here?

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