Pancreatectomy With Arterial Resection for Pancreatic Adenocarcinoma: How Can It Be Done Safely and With Which Outcomes?

Bachellier, Philippe; Addeo, Pietro; Faitot, François; Nappo, Gennaro; Dufour, Patrick

doi:10.1097/sla.0000000000003010

Cited by 106 publications

(89 citation statements)

References 64 publications

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“…Another kind of patient the PAMG could impact are the 20 to 30% percent of patients diagnosed with a locallyadvanced disease. If pancreatectomy and simultaneous arterial resection has traditionally been considered as a general contraindication to resection [19], some of these patients with good prognosis might indeed benefit from aggressive surgical approaches [20].…”

Section: Discussionmentioning

confidence: 99%

“…After 3 passages, tumors were isolated and RNA extracted using the miRneasy mini kit (Qiagen). RNA-seq was performed as previously described [9,20] using Illumina's TrueSeq Stranded RNA LT protocol to obtain 100b paired-end reads. RNA-seq reads were mapped using STAR and SMAP on the human hg19 and mouse mmu38 genomes.…”

Section: Pacaomics Patient Derived Tumor Xenograft and Rna-sequencingmentioning

confidence: 99%

“…The unsupervised clustering of the 76 PDX transcriptomic profiles was performed as in a previous unsupervised classification of a subset of these PDX [20]. The consensus cluster plus approach was applied on subsets of the most varying genes in the expression matrix using a Pearson distance and aggregating over several linkage methods (average, complete and Ward).…”

Section: Unsupervised Clustering Of Pdxmentioning

confidence: 99%

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Establishment of a pancreatic adenocarcinoma molecular gradient (PAMG) that predicts the clinical outcome of pancreatic cancer

Nicolle

Blum

Duconseil

et al. 2020

Preprint

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BACKGROUND: A significant gap in pancreatic ductal adenocarcinoma (PDAC) patient's care is the lack of molecular parameters characterizing tumors and allowing a personalized treatment. The goal of this study was to examine whole PDAC transcriptomic profiles to define a signature that would predict aggressiveness and treatment responsiveness better than done until now. METHODS AND PATIENTS: Tumors were obtained from 76 consecutive resectable (n=40) or unresectable (n=36) tumors. PDAC were transplanted in mice to produce patient-drived xenografts (PDX). PDX were classified according to their histology into five groups, from highly undifferentiated to well differentiated. This classification resulted strongly associated with tumors aggressiveness. A PDAC molecular gradient (PAMG) was constructed from PDX transcriptomes recapitulating the five histological groups along a continuous gradient. The prognostic and predictive value for PMAG was evaluated in: i/ two independent series (n=598) of resected tumors; ii/ 60 advanced tumors obtained by diagnostic EUS-guided biopsy needle flushing and iii/ on 28 biopsies from mFOLFIRINOX treated metastatic tumors. RESULTS: A unique transcriptomic signature (PAGM) was generated with significant and independent prognostic value. PAMG significantly improves the characterization of PDAC heterogeneity compared to non-overlapping classifications as validated in 4 independent series of tumors (e.g. 308 consecutive resected PDAC, HR=0.321 95% CI [0.207;0.5] and 60 locallyadvanced or metastatic PDAC, HR=0.308 95% CI [0.113;0.836]). The PAMG signature is also associated with progression under mFOLFIRINOX treatment (Pearson correlation to tumor response: -0.67, p-value < 0.001). CONCLUSION: We identified a transcriptomic signature (PAMG) that, unlike all other stratification schemas already proposed, classifies PDAC along a continuous gradient. It can be performed on formalin-fixed paraffin-embedded samples and EUS-guided biopsies showing a strong prognostic value and predicting mFOLFIRINOX responsiveness. We think that PAMG could unify all PDAC preexisting classifications inducing a shift in the actual paradigm of binary classifications towards a better characterization in a gradient.

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Section: Discussionmentioning

confidence: 99%

Section: Pacaomics Patient Derived Tumor Xenograft and Rna-sequencingmentioning

confidence: 99%

Section: Unsupervised Clustering Of Pdxmentioning

confidence: 99%

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Establishment of a pancreatic adenocarcinoma molecular gradient (PAMG) that predicts the clinical outcome of pancreatic cancer

Nicolle

Blum

Duconseil

et al. 2020

Preprint

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“…Both the Mayo Clinic group (24,120) and Bachellier et al (121) reported more than 100 ARs (LE 4). In 2018, the Mayo Clinic group reported results in 111 patients who underwent pancreatectomy with AR [HA (n = 60), celiac (n = 49), SMA (n = 15), multiple ARs (n = 15)] including 55% with reconstruction and 51% with simultaneous VRs (120).…”

Section: Commentsmentioning

confidence: 99%

“…Bachellier et al (121) reported 118 pancreatectomies (51 PD, 18 TP, and 49 DP) with ARs [CA (50), HA (29), SMA (35), and other segments (4)] including 85% with reconstruction and 89% with simultaneous VR (LE 4). Overall mortality and morbidity were 5.1 and 41.5%, respectively.…”

Section: Commentsmentioning

confidence: 99%

Vascular Resection for Pancreatic Cancer: 2019 French Recommendations Based on a Literature Review From 2008 to 6-2019

Delpero

Sauvanet

2020

Front. Oncol.

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Pancreatoduodenectomy for Pancreatic Cancer

Kinny‐Köster

Cameron

2023

The Pancreas

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Pancreatectomy With Arterial Resection for Pancreatic Adenocarcinoma: How Can It Be Done Safely and With Which Outcomes?

Abstract: In a specialized setting, P-AR for locally advanced pancreatic adenocarcinoma can be performed safely with limited mortality and morbidity. Negative resection margin and the absence of associated venous invasion might predict favorable long-term outcomes.

Cited by 106 publications

References 64 publications

Establishment of a pancreatic adenocarcinoma molecular gradient (PAMG) that predicts the clinical outcome of pancreatic cancer

Establishment of a pancreatic adenocarcinoma molecular gradient (PAMG) that predicts the clinical outcome of pancreatic cancer

Vascular Resection for Pancreatic Cancer: 2019 French Recommendations Based on a Literature Review From 2008 to 6-2019

Pancreatoduodenectomy for Pancreatic Cancer

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