Influence of Perineural Invasion on Survival and Recurrence in Patients with Resected Pancreatic Cancer

Zhang, Jun Feng; Hua, Rong; Sun, Yanjun; Liu, Wei; Huo, Yan Miao; Liu, De Jun; Li, Jiao

doi:10.7314/apjcp.2013.14.9.5133

Cited by 34 publications

(24 citation statements)

References 62 publications

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“…Understanding neural plasticity, neural invasion, and neuropathic pain is of important translational relevance, as neural invasion and pain sensation are independent prognostic factors for survival in patients with pancreatic cancer. 14,102,103 Conceivably, neural alterations in pancreatic cancer and chronic pancreatitis are not mere bystanders, but active shapers of disease evolution and progression, as was shown for gastric cancer. 89 Current in vivo models of chronic pancreatitis and pancreatic cancer do not provide sufficient mechanistic evidence for neuropathic pain being the result of pancreatic neural plasticity.…”

Section: Discussionmentioning

confidence: 90%

Neural plasticity in pancreatitis and pancreatic cancer

Demir

Frieß

Ceyhan

2015

Nat Rev Gastroenterol Hepatol

180

146

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Pancreatic nerves undergo prominent alterations during the evolution and progression of human chronic pancreatitis and pancreatic cancer. Intrapancreatic nerves increase in size (neural hypertrophy) and number (increased neural density). The proportion of autonomic and sensory fibres (neural remodelling) is switched, and are infiltrated by perineural inflammatory cells (pancreatic neuritis) or invaded by pancreatic cancer cells (neural invasion). These neuropathic alterations also correlate with neuropathic pain. Instead of being mere histopathological manifestations of disease progression, pancreatic neural plasticity synergizes with the enhanced excitability of sensory neurons, with Schwann cell recruitment toward cancer and with central nervous system alterations. These alterations maintain a bidirectional interaction between nerves and non-neural pancreatic cells, as demonstrated by tissue and neural damage inducing neuropathic pain, and activated neurons releasing mediators that modulate inflammation and cancer growth. Owing to the prognostic effects of pain and neural invasion in pancreatic cancer, dissecting the mechanism of pancreatic neuroplasticity holds major translational relevance. However, current in vivo models of pancreatic cancer and chronic pancreatitis contain many discrepancies from human disease that overshadow their translational value. The present Review discusses novel possibilities for mechanistically uncovering the role of the nervous system in pancreatic disease progression.

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Section: Discussionmentioning

confidence: 90%

Neural plasticity in pancreatitis and pancreatic cancer

Demir

Frieß

Ceyhan

2015

Nat Rev Gastroenterol Hepatol

180

146

View full text Add to dashboard Cite

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“…Approximately 60-70% of exocrine pancreatic cancers are localized to the head of the pancreas, while 20-25% are in the body/tail and the remainder involve the whole organ (Porta et al, 2005). Age and operation status were found to be independent prognostic factors for overall survival (OS) and perineural invasion was an independent and poor prognostic factor (Canyilmaz et al, 2013;Zhang et al, 2013). Racial and socioeconomic factors were associated with about 2% difference in absolute cause specific survival (Cheung, 2013).…”

Section: Introductionmentioning

confidence: 99%

Pancreatic Carcinoma, Thrombosis and Mean Platelet Volume: Single Center Experience from the Southeast Region of Turkey

Afşar¹,

Günaldı²,

Kum³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: The aim of this study was to investigate the general characteristics of patients with deep vein thrombosis (DVT) and pancreatic cancer as well as evaluate the relationship between mean platelet volume (MPV), DVT and survival. Materials and Methods: Seventy-seven patients with pancreatic cancer, who were admitted to Cukurova University Medical Faculty, Department of Medical Oncology, were enrolled in the study Results: The mean age was 59±20. Forty-nine (63.6%) were men and 28 women (36.4%) . Sixty-eight (88.3%) patients had adenocarcinoma and 9 (11.7%) had a malignant epithelial tumor. Thirty-six (46.7%) had liver metastasis at diagnosis. Twenty-six (33.8%) patients were alive, 20 (26%) were dead and in 31 (40.2%) the status was unknown. Only 14 (18.1%) patients had DVT. In 42 (54.5%) patients MPV values were normal, in 28 (36.4%) patients they were above normal, and in 7 (9.1%) patients they were below normal. There was no statistically significant difference between gender, tumour localization, chemotherapy and survival rates (p:0.56, p:0.11, p:0.21). There was no significant difference between DVT, gender, localisation, histological subtype, the presence of metastasis, stage and if the patient had been treated with chemotherapy (p:0.5, p:0.6, p:0.2, p:0.32, p:0.1, p:0.84). There was also no significant difference between MPV and DVT (p:0.57) but there was a significant difference between liver metastasis and DVT (p:0.02). Age, stage, the presence of metastasis and DVT were prognostic in pancreatic cancer patients. Conclusions: Cases of pancreatic cancer with liver metastasis should be studied more carefully as thrombosis is more common in these patients.

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“…With the increased awareness of LSPH and developments in diagnostic techniques, more and more cases of LSPH secondary to pancreatic cancer have been reported over the past two decades. In recent years, the incidence of pancreatic cancer is gradually changed (Canyilmaz et al, 2013;Chen et al, 2013;Cheung et al, 2013;Zahir et al, 2013;Zhang et al, 2013). However, the actual risk caused by this secondary LSPH to primary pancreatic cancer, and the indications of radical operation for pancreatic cancer with secondary LSPH, remain unclear.…”

Section: Lsph Was First Reported By Greenwald and Wasch Inmentioning

confidence: 99%

Effects of Secondary Left-sided Portal Hypertension on the Radical Operation Rate and Prognosis in Patients with Pancreatic Cancer

Zhang¹,

Wen²,

Kong³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Objective: To investigate the effects of secondary left-sided portal hypertension (LSPH) on the radical operation rate of patients with pancreatic cancer and systemically evaluate the prognosis of patients with LSPH secondary to pancreatic cancer after radical surgery. Materials and Methods: The data of patients with pancreatic cancer who underwent laparotomy over a 15-year period in Department of Hepatobiliary Surgery of Chinese PLA Air Force General Hospital from Jan. 1, 1997, to Jun. 30, 2012 was retrospectively reviewed. Results: A total of 362 patients with pancreatic cancer after laparotomy were selected, including 73 with LSPH and 289 without LSPH. Thirty-five patients with LSPH (47.9%) and 147 without non-LSPH (50.9%) respectively underwent radical operations. No significant difference was found between these two groups regarding the total resection rate and stratified radical resection rate according to different pathological types and cancer locations. The mean and median survival time of patients after radical operation in LSPH group were 13.9±1.3 months and 14.8 months, respectively, while those in non-LSPH group were 22.6±1.4 months and 18.4 months, respectively(P<0.05). Conclusions: Radical operations for pancreatic cancer and secondary LSPH are safe and effective. Because high-grade malignancy and poor prognosis are closely associated, the decision for radical surgery should be made more meticulously for the patients with pancreatic cancer.

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Influence of Perineural Invasion on Survival and Recurrence in Patients with Resected Pancreatic Cancer

Cited by 34 publications

References 62 publications

Neural plasticity in pancreatitis and pancreatic cancer

Neural plasticity in pancreatitis and pancreatic cancer

Pancreatic Carcinoma, Thrombosis and Mean Platelet Volume: Single Center Experience from the Southeast Region of Turkey

Effects of Secondary Left-sided Portal Hypertension on the Radical Operation Rate and Prognosis in Patients with Pancreatic Cancer

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