Metastases of pancreatic adenocarcinoma: A systematic review of literature and a new functional concept

Cannistrà, Marco; Ruggiero, Michele; Zullo, Alessandra; Serafini, Simone; Grande, Raffaele; Nardo, Bruno

doi:10.1016/j.ijsu.2015.04.093

Cited by 30 publications

(28 citation statements)

References 125 publications

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“…Most pancreatic tumors are located in the head of pancreas (47-65%), followed by the body and tail (15-18%) 4 . Tobacco smoking, diabetes mellitus, obesity, heavy alcohol drinking, family history, certain genetic polymorphisms, and chronic pancreatitis have been considered as risk factors for pancreatic adenocarcinoma 5 . Surgical resection remains the only potentially curative treatment.…”

Section: Introductionmentioning

confidence: 99%

Clinical Outcome of Exocrine Pancreatic Adenocarcinoma: A Single Center Experience

Gohar

Megahid

Rizk

et al. 2017

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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Background: Pancreatic carcinoma is an uncommon tumor with a high mortality rate. Because of the late presentation of the disease, only a small percent of patients are candidate for surgery. Aim: To assess the epidemiology and the clinical outcome of patients diagnosed with pancreatic adenocarcinoma presented to the Clinical Oncology Department at Menoufia University. Methods: All patients presenting with exocrine pancreatic carcinoma from January 2007 to December 2011 were included. Epidemiological features of patients and their treatment details and outcome were collected retrospectively from the medical records. An equal number of matched controls were interviewed and filled a questionnaire to identify possible risk factors. Results: Exocrine pancreatic adenocarcinoma represented 1.4 % of all cancer patients treated at our institution. The study included 76 patients and 76 controls. Pancreatic cancer patients were significantly more likely to be overweight when compared to controls (OR= 2.51, 95%CI: 1.04-6.06). Diabetes mellitus and smoking were significantly more prevalent among patients (OR= 2.36, 95%CI: 1.23-4.54; OR= 2, 95%CI: 1.05-3.81; respectively). The median time to progression was 12 weeks (95%CI: 9.46-14.53) and the median overall survival was 16 weeks (95%CI: 12.22-19.78). Patients with earlier tumor stage and those who underwent surgery followed by adjuvant chemotherapy had significantly better overall survival (p=0.02 and <0.001, respectively). Conclusion: Exocrine pancreatic adenocarcinoma is an uncommon tumor among cancer patients treated at the Clinical Oncology Department of Menoufia University. Diabetes mellitus, higher body mass index and smoking are significantly more prevalent in pancreatic carcinoma patients. Earlier tumor stage and undergoing surgery followed by chemotherapy are associated with statistically significant better overall survival.

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Section: Introductionmentioning

confidence: 99%

Clinical Outcome of Exocrine Pancreatic Adenocarcinoma: A Single Center Experience

Gohar

Megahid

Rizk

et al. 2017

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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“…Additionally, histological examination of tissues taken from animals sacrificed at the same early time-point from both cohorts of mice revealed that mice injected with AsPC-1 WT cells had pronounced adenocarcinoma tumor cell presence in both the lung and the peritoneum (red arrow, representative images, Figure 6B and Supplementary Figure 13), organ commonly associated with PDAC metastasis [39], while mice injected with AsPC-1 MOE cells had normal lung and peritoneal tissue upon harvest (green arrow, representative images, Figure 6B and Supplementary Figure 13). Taken together, these data show that expression of MTSS1 plays a critical role in the suppression of cell invasion and migration in vitro ; moreover, increasing MTSS1 expression in metastatic cells increases survival in vivo .…”

Section: Resultsmentioning

confidence: 99%

Loss of MTSS1 results in increased metastatic potential in pancreatic cancer

et al. 2017

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Pancreatic ductal adenocarcinoma (PDAC) has a 5-year survival rate of 7%. This dismal prognosis is largely due to the inability to diagnose the disease before metastasis occurs. Tumor cell dissemination occurs early in PDAC. While it is known that inflammation facilitates this process, the underlying mechanisms responsible for this progression have not been fully characterized. Here, we functionally test the role of metastasis suppressor 1 (MTSS1) in PDAC. Despite evidence showing that MTSS1 could be important for regulating metastasis in many different cancers, its function in PDAC has not been studied. Here, we show that loss of MTSS1 leads to increased invasion and migration in PDAC cell lines. Moreover, PDAC cells treated with cancer-associated fibroblast-conditioned media also have increased metastatic potential, which is augmented by loss of MTSS1. Finally, overexpression of MTSS1 in PDAC cell lines leads to a loss of migratory potential in vitro and an increase in overall survival in vivo. Collectively, our data provide insight into an important role for MTSS1 in suppressing tumor cell invasion and migration driven by the tumor microenvironment and suggest that therapeutic strategies aimed at increasing MTSS1 levels may effectively slow the development of metastatic lesions, increasing survival of patients with PDAC.

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“…An extensive systematic literature review was performed by Cannistra and colleagues to determine the impact and outcomes of metastasis in pancreatic cancer [10]. Most studies…”

Section: Plos Onementioning

confidence: 99%

“…Randomized trials have addressed resection combined with perioperative chemotherapy in colorectal cancer and have reported better outcomes using these strategies. Several case series have pointed out benefit of locoregional treatments in liver metastasis in MPC, but randomized data on the subject are scarce [10,27]. Our results show that liver metastasis confer a HR for death of 1.53 with 95% CI of 1.15 to 2.02 (p-value 0.003), without significant heterogeneity (I2 = 5.03%) and a HR for risk of relapse of 1.96 with 95% CI of 1.28 to 2.99 (p-value 0.002).…”

Section: Plos Onementioning

confidence: 99%

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The impact of metastatic sites in advanced pancreatic adenocarcinoma, systematic review and meta-analysis of prospective randomized studies

et al. 2020

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The real impact of specific sites of metastasis on prognosis of metastatic pancreatic cancer (MPC) is unknown. To evaluate the association of specific metastatic sites and survival outcomes in MPC a systematic literature review was performed including prospective randomized trials of systemic treatments in metastatic pancreatic cancer indexed in PubMed, Embase and Web of Science. Data regarding systemic treatment regimens, progression free survival and overall survival were extracted. The outcomes were compared using a random effects model. The index I2 and the graphs of funnel plot were used for the interpretation of the data. Of 1,052 abstracts, 7 randomized trials were considered eligible with a combined sample size of 2,975 MPC patients. Combining the studies with meta-analysis, we could see that patients with liver metastasis had a HR for death of 1.53 with 95% CI of 1.15 to 2.02 (p-value 0.003) and HR for risk of progression of 1.96 with 95% CI of 1.28 to 2.99 (p-value 0.002), without significant heterogeneity. Having two or more sites of metastasis comparing to one site did not have impact on overall survival; RR of 1.05 with 95% CI 0.91 to 1.23 (p-value 0.493). In conclusion, liver metastasis confers worse outcomes among patients with MPC. Apparently, multiple metastatic sites do not present worse prognosis when compared with only one organ involved, therefore, demonstrating the severity of this disease. Prospective studies evaluating other treatments are necessary to address the impact of local treatments in liver metastasis in MPC. OPEN ACCESSCitation: Usón PLS, Junior, Tolentino FD'AvilaS, Santos VM, Rother ET, Maluf FC (2020) The impact of metastatic sites in advanced pancreatic adenocarcinoma, systematic review and metaanalysis of prospective randomized studies. PLoS ONE 15(3): e0230060. https://doi.org/10.

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Metastases of pancreatic adenocarcinoma: A systematic review of literature and a new functional concept

Abstract: An updated insight into the world of Pancreatic Tumors might help physicians in better evaluating mechanisms of metastases, patients selection and survival and in programming appropriate interventions to modify the worst outcomes of advanced disease.

Cited by 30 publications

References 125 publications

Clinical Outcome of Exocrine Pancreatic Adenocarcinoma: A Single Center Experience

Clinical Outcome of Exocrine Pancreatic Adenocarcinoma: A Single Center Experience

Loss of MTSS1 results in increased metastatic potential in pancreatic cancer

The impact of metastatic sites in advanced pancreatic adenocarcinoma, systematic review and meta-analysis of prospective randomized studies

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